Fatal hemolytic disease of the fetus and newborn possibly due to anti‐Jr^a

Fatal hemolytic disease of the fetus and newborn caused by anti-Jra antibody: A case report and literature review

“…In one report, the mother harbored anti-Jr a antibodies in her serum, although HDFN was not observed [4]. As shown in Table 1, the patients in three reports [6,7,10] showed severe HDFN clinical manifestations, and two [6,7] experienced abortion. Our case is the third reported fetal death owing to severe fetal anemia [4,6,7].…”

“…The main feature of previous reports [2,6,7,[10][11][12][13][14][15][16][17], including severe cases, is multiparity. In our case, immunization might have occurred during a previous abortion.…”

“…A Jr a -negative patient with anti-Jr a antibody who was transfused with Jr a -positive RBCs showed no severe complication [5]. This diversity in clinical manifestations might be because of the different in vivo activity of the anti-Jr a antibody, and antibody subclasses can provide one possible explanation for this difference [6,7,17]. In IgG subclass analysis for anti-Jr a antibodies, IgG1, associated with complement activation, was the predominant clone [6].…”

“…Mild, delayed hemolytic transfusion reactions and one case of an acute hemolytic transfusion reaction have been reported to be caused by anti-Jr a [4,5]. Although the anti-Jr a -associated hemolytic disease of the fetus and newborn (HDFN) is generally considered mild-to-moderate, two fatal cases have previously been published [6,7].…”

Hemolytic disease of the newborn due to anti‐Jra from a Chinese mother with one novel and one classic heterozygous mutation

“…Anti‐Jr a can lead to DAT‐positive or mild neonatal jaundice; it is also a dangerous antibody in pregnancy and has been implicated in severe and fatal HDFN. From the reviewed literatures, we discovered several serious cases, including stillbirth 16,34 . Aside from influencing the foetus, the antibody can also cause several problems to the mother.…”