In utero development of a warm-reactive autoantibody in a severely jaundiced neonate.

Douglas P. Blackall, Linda H. Liles, Ajay Talati

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The fetus and neonate are widely considered to be immunologically immature. However, there are rare case reports of RBC alloantibody and autoantibody development. STUDY DESIGN AND METHODS: This report describes the case of a severely jaundiced full-term boy neonate presenting at birth with an IgG warm-reactive autoantibody. RESULTS: Mother and neonate were both blood group A, D+. The mother had a negative antibody screen at 18 weeks' gestation and a negative DAT and antibody screen at the time of delivery. The neonate was born with a strongly reactive DAT (IgG) and a panreactive eluate. The serum also contained a panreactive antibody, and all crossmatches were incompatible. The neonate had a bilirubin of 12.5 mg per dL at birth, which peaked at 22.5 mg per dL. However, there was no overt evidence of hemolysis, as evidenced by normal serial Hct levels and reticulocyte counts. The neonate responded well to phototherapy and did not require either simple or exchange transfusion. The neonate's warm-reactive autoantibody maintained its original strength of reactivity on follow-up testing performed at 2 weeks and 2 months of age. CONCLUSIONS: This report describes a rare case of apparent in utero RBC autoantibody development. The fetal/neonatal immune response to blood group antigens is reviewed.

Original languageEnglish (US)
Pages (from-to)44-47
Number of pages4
JournalTransfusion
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2002

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Jaundice
Autoantibodies
Newborn Infant
Antibodies
Immunoglobulin G
Mothers
Parturition
Reticulocyte Count
Isoantibodies
Phototherapy
Blood Group Antigens
Hemolysis
Bilirubin
Fetus
Pregnancy
Serum

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this

In utero development of a warm-reactive autoantibody in a severely jaundiced neonate. / Blackall, Douglas P.; Liles, Linda H.; Talati, Ajay.

In: Transfusion, Vol. 42, No. 1, 01.01.2002, p. 44-47.

Research output: Contribution to journalArticle

Blackall, Douglas P. ; Liles, Linda H. ; Talati, Ajay. / In utero development of a warm-reactive autoantibody in a severely jaundiced neonate. In: Transfusion. 2002 ; Vol. 42, No. 1. pp. 44-47.
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