Fatal hemolytic disease of the fetus and newborn associated with anti‐Jr^a

Abstract

This is the first documented case of fatal HDFN due to anti-Jr(a). Therefore, we recommend close monitoring of pregnant women with a high-titer anti-Jr(a), especially those with an incompatible transfusion history and/or multiple pregnancies. This case report provides new arguments about the clinical significance of anti-Jr(a) in the transfusion setting.

Null alleles of ABCG2 encoding the breast cancer resistance protein define the new blood group system Junior

“…who have the Jr(a−) blood type. Anti-Jr a may be responsible for acute hemolytic transfusion reactions 3 but is of particular concern in obstetrics, as it can cause fatal hemolytic disease of the fetus and newborn (HDFN) 4 . In fact, anti-Jr a is usually detected during pregnancy of Jr(a−) mothers, whose Jr(a−) blood type remains ignored until they develop an anti-Jr a induced by the Jr(a+) cells of their fetus.…”

“…In fact, anti-Jr a is usually detected during pregnancy of Jr(a−) mothers, whose Jr(a−) blood type remains ignored until they develop an anti-Jr a induced by the Jr(a+) cells of their fetus. While the Jr(a−) blood type is rare worldwide, many cases have been found in the Japanese population 5,6 and in European Gypsy communities 4,7 . Transfusion support of Jr(a−) patients is highly difficult to manage because of the extreme rarity of Jr(a−) blood donors.…”

Hemolytic Disease of the Newborn Associated with Anti-JraAlloimmunization in a Twin Pregnancy: The First Case Report in Korea

“…The Jr a antigen has also been reported to be fully developed at birth [7]. Although anti-Jr a antibodies can be stimulated by a first pregnancy, HDNF associated with anti-Jr a antibody was thought to occur in subsequent pregnancies [6]. However, in our case, the mother was nulliparous and had One of the difficulties in identifying anti-Jr a antibodies is the lack of commercially available antisera.…”

“…A human monoclonal anti-Jr a antibody has been produced from a human-mouse heterohybridoma (HMR0921) [20]. However, the biochemical structure of the Jr a antigen and the molecular basis of the Jr(a-) phenotype are currently unknown [6]. Our laboratory has been identifying anti- Nevertheless, close monitoring of the patient is necessary while performing subsequent transfusions.…”

Junior and Langereis Blood Group Systems

“…Anti -Jr a is a dangerous antibody in pregnancy and has been implicated in severe and fatal HDFN [11,12,19,22] , although in other pregnancies with maternal anti -Jr a indications of HDFN have been no more than a positive DAT on cord cells or mild neonatal jaundice [5,16,17,20,25] .…”