Haemolytic Disease of the
Newborn due to Anti-M

Duguid, J.K.M.; Bromilow, I.M.; Entwistle, G.D.; Wilkinson, R.

doi:10.1159/000462927

Cited by 10 publications

(8 citation statements)

References 5 publications

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“…The third and fourth cases are both reports of three fetal losses and high anti‐M titers, 1024 and 4096, respectively 4,5 . The fifth case is an anti‐M immunization with a titer of 16, where the male infant required an exchange transfusion 6 . Finally, the sixth report describes a woman with seven intrauterine deaths in Gestational Weeks 10 to 33.…”

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confidence: 97%

Fetal hemolytic anemia and intrauterine death caused by anti‐M immunization

et al. 2007

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Fetal hemolytic anemia and intrauterine death caused by anti‐M immunization

et al. 2007

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“…However, the incidence of severe hemolytic disease of newborn due to anti‐M is extremely rare 1,4,6 . Although several severe hemolytic disease of newborn due to anti‐M have been reported in the literature, 3,4,7,8 in a retrospective study in which 115 pregnant women with anti‐M antibody over a 26 year period were evaluated, no case of clinically significant hemolytic disease of the newborn was seen 6 …”

Section: Discussionmentioning

confidence: 99%

Treatment of MN subgroup incompatibility with intravenous immunoglobulin in a newborn

Gürsoy

Tekinalp

Yiğit

et al. 2007

Pediatrics International

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“…[1][2][3] Case reports implicate maternal antibodies against the M antigen on neonatal RBCs in varying severities of hemolytic disease of the fetus and newborn (HDFN). [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] We describe the case of a newborn with passively acquired immunoglobulin (Ig) G anti-M with an atypical reactivity pattern that proved clinically relevant in provoking hemolytic anemia and suppressing erythropoiesis, resulting in reticulocytopenia with prolonged anemia.…”

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confidence: 99%

Hemolytic disease and reticulocytopenia of the newborn attributable to maternal immunoglobulin G anti‐M reacting optimally at cold temperatures

et al. 2021

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Background: Hemolytic disease of the fetus and newborn (HDFN) attributable to anti-M is rare, although case reports implicate anti-M in varying severities of HDFN, including fetal hydrops and intrauterine death. Case Description: We describe the case of a newborn with HDFN associated with an atypical immunoglobulin (Ig) G anti-M that reacted best at cold temperatures. The maternal antibody detected in pregnancy was not reactive at 37°C, and a direct antiglobulin test (DAT) on red blood cells (RBCs) from the newborn was negative, suggesting an anti-M that should not have been clinically relevant. However, the infant developed hyperbilirubinemia (bilirubin level, 17.6 mg/dL), hemolytic anemia (hemoglobin nadir, 5.5 g/dL), and reticulocytopenia. Laboratory testing demonstrated the presence of an IgG anti-M in maternal and neonatal samples reacting best at 4°C. This passively acquired IgG anti-M provoked hemolytic anemia in the infant and likely suppressed erythropoiesis, resulting in reticulocytopenia with prolonged anemia. He was treated for IgG anti-M HDFN with 10 intravenous Ig infusions and 10 days of oral prednisone followed by a taper. He required seven transfusions with M− RBCs. His hemoglobin level normalized at 3 months of age. Follow-up at 2 years revealed no hematologic or neuro-developmental concerns. Conclusion: To our knowledge, this is the second report of HDFN attributable to an IgG anti-M reacting preferentially at cold temperature with no 37°C reactivity. Clinically relevant IgG anti-M may elude standard testing. Early recognition and testing for cold-reacting IgG anti-M should be considered for newborns with hemolysis, a negative DAT, and prolonged anemia.

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Haemolytic Disease of the Newborn due to Anti-M

Cited by 10 publications

References 5 publications

Fetal hemolytic anemia and intrauterine death caused by anti‐M immunization

Fetal hemolytic anemia and intrauterine death caused by anti‐M immunization

Treatment of MN subgroup incompatibility with intravenous immunoglobulin in a newborn

Hemolytic disease and reticulocytopenia of the newborn attributable to maternal immunoglobulin G anti‐M reacting optimally at cold temperatures

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