Severe hemolytic disease in a newborn caused by anti-k antibodies

Hemolytic disease of the newborn (HDN) is a consequence of the mother’s alloimmunization towards fetal erythrocyte antigens. Maternal IgG class antibodies cross the placenta into the fetal circulation and attach to the antigenic sites on the surface of the erythrocytes, hence destroying them. Hydrops fetalis is the most severe form of the disease, but hyperbilirubinemia and anemia are more common. The incidence of HDN caused by anti-K antibodies comes immediately after the incidence of HDN caused by anti-D antibodies. During the 1980’s a different mechanism was noted for anti-D and anti-K antibodies. Suppression of erythropoesis, rather than hemolysis, is the predominant mechanism in HDN related to Kell aloimmunization, and may occur during the first pregnancy. In our case, the aloimmunization of the K-negative mother occured during pregnancy with a K-positive fetus, leading to severe anemia in the newborn. Serological findings of anti-K antibodies in the mother’s serum, and the presence of Kell antigens on the surface of the child’s erythrocytes, compiled with the father’s Kell antigen status established the diagnosis. Due to timely and adequate treatment with transfusions, the girl recovered completely without consequences to growth and development.
Keywords: ERYTHROBLASTOSIS, FETAL – blood, immunology, therapy; KELL BLOOD-GROUP SYSTEM – immnunology; ISOANTIBODIES – blood
Category: Case report
Volume: Vol. 52, No 4, october - december 2008
Authors: M. Starčević, D. Sović, J. Dodig ,V. Zah-Mataković,Z. Zakanj
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