A Fatal Case of Severe Hemolytic Disease of Newborn Associated with Anti-Jk^b

Abstract

The Kidd blood group is clinically significant since the Jk antibodies can cause acute and delayed transfusion reactions as well as hemolytic disease of newborn (HDN). In general, HDN due to anti-Jkb incompatibility is rare and it usually displays mild clinical symptoms with a favorable prognosis. Yet, we apparently experienced the second case of HDN due to anti-Jkb with severe clinical symptoms and a fatal outcome. A female patient having the AB, Rh(D)-positive boodtype was admitted for jaundice on the fourth day after birth. At the time of admission, the patient was lethargic and exhibited high pitched crying. The laboratory data indicated a hemoglobin value of 11.4 mg/dL, a reticulocyte count of 14.9% and a total bilirubin of 46.1 mg/dL, a direct bilirubin of 1.1 mg/dL and a strong positive result (+++) on the direct Coomb's test. As a result of the identification of irregular antibody from the maternal serum, anti-Jkb was detected, which was also found in the eluate made from infant's blood. Despite the aggressive treatment with exchange transfusion and intensive phototherapy, the patient died of intractable seizure and acute renal failure on the fourth day of admission. Therefore, pediatricians should be aware of the clinical courses of hemolytic jaundice due to anti-Jkb, and they should be ready to treat this disease with active therapeutic interventions.

Jk3 alloantibodies during pregnancy—blood bank management and hemolytic disease of the fetus and newborn risk

“…Kidd system antibodies are clinically significant and capable of causing acute and delayed hemolytic transfusion reactions, which can range from mild to severe or even fatal. In contrast, Kidd‐associated HDFN is generally mild, although select severe and fatal cases have been reported . Alloantibodies directed against the Kidd antigens are primarily composed of IgG or less commonly a mixture of IgG and IgM.…”

Hemolytic Disease of the Newborn Due to Anti-Jkb: Case Report and Review of the Literature

“…When alloimmunization occurs it can potentially lead to a HDN which usually has a mild clinical course and a good outcome. There are only thirteen cases of anti-Jkb related HDN reported in medical literature (Table 2) [12][13][14][15][16][17][18][19][20][21][22][23]. Most of them (76.92 %) were mild and the newborn required either phototherapy (4 cases: 30.76 %) or no treatment at all.…”

“…Despite of these data, 2 cases (15.38 %) had a fatal outcome. One of them developed hidrops fetalis and intrauterine death [21], and the second one died of acute renal failure 4 days after birth in spite of intensive treatment with exchange transfusion and phototherapy for 3 days [17].…”

Manejo de la embarazada con isoinmunización por anticuerpos irregulares

“…En este grupo, se han descrito tanto reacciones transfusionales agudas y cróni-cas, como enfermedad hemolítica perinatal. En general, la enfermedad hemolítica perinatal es poco frecuente, leve y de buen pronóstico, sin embargo se han reportado casos severos incluso con resultado de pérdida fetal (39).…”