Hemolytic Disease of the Newborn Due to Anti‐PP_IP^k (Anti‐Tj^a)

Abstract

A newborn infant of genotype P2p suffering from ABO-like hemolytic disease was born to a mother of the very rare genotype pp. The disease was severe enough to require exchange transfusions with pp blood. The mother and other members of the family with the same rare pp blood provided compatible donor blood for transfusions of the mother herself and for replacement transfusion of her affected infant. The mothers serum contained IgM molecules and also IgG molecules capable of crossing the placenta to induce a hemolytic process on the infant's red blood cells. The genotype of the P1 negative father was very likely P2P2 so that the genotype of the affected infant had to be P2p. A search of the literature revealed an earlier report from Japan in which the genotype of the P1 positive father was P1P2. As was to be expected the genotype of this affected infant was P2p.

Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p

“…She had had extensive physical and endocrinological investigations, and all were normal. Her rare blood group was first discovered in a family study when her sister was found to be p [11], The patient's serum contained anti-PPiPk, which caused in vitro hemolysis of all P-positive red cells, including those of her husband.…”

“…There is no doubt that anti-PPiPk has been responsible for hemolytic disease of the newborn [11,16]. Kato et al [17] found that in p individuals 25% of anti-P and 75% of anti-Pk were IgG, and in 1985 Söderström et al [18] examined the IgG classes of anti-P and anti-Pk from the sera of p individuals by enzyme-linked immunosorbent assay, against purified glycolipids, and found that there was almost total restriction to the immunoglobulin sub class IgG3.…”

Successful Treatment by Double Filtrate Plasmapheresis in a Pregnant Woman With the Rare P Blood Group and a History of Multiple Early Miscarriages

“…The P 1 antigen is reported to inhibit expression of P and P k antigen (7). Although several cases have been reported in which P type incompatibility caused hemolytic disease (22), the p‐type incompatible pregnancy does not usually cause hemolytic disease in newborns, as the Rh incompatible pregnancies do. For that reason, antibody removal in late pregnancy might be unnecessary.…”

“…The P 1 antigen is reported to inhibit expression of P and P k antigen (7). Although several cases have been reported in which P type incompatibility caused hemolytic disease (22), the p-type incompatible For that reason, antibody removal in late pregnancy might be unnecessary. In the present case, we continued therapy to ensure the safety of the fetus because no adverse effect of DFPP was observed, and because the precise mechanism and the effect of anti-PP 1 P k antibody had not yet been elucidated.…”

P1PK, Globoside, and FORS Blood Group Systems, Plus Some Other Related Blood Groups

“…Most P 1 or P 2 babies of p mothers have no sign of HDFN, although there are a few reports of mild HDFN [145,186] . Many women with the p phenotype have been ascertained through habitual abortion, though other p women have several live children.…”