Severe hemolytic disease of the fetus and the newborn associated with anti-Vw (Vw)

Moncharmont, P.; Buclet, Dominique; Trouilloud, C; Peyrard, Thierry; Rigal, Dominique

doi:10.3109/14767050903366085

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…Figure 1A summarizes the number of reports and antibody specificities. 5,[9][10][11][12][13][14][15][16][17][18][19][20][21] Obstetric cases are restricted to patients and their partners of Southeast Asian ancestry. The Mur antigen has a prevalence of less than 0.1% in whites and blacks but is 3% to 10% in Southeast Asian populations (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Some transfusion incompatibility and obstetric problems are associated with alloantibodies against MNS hybrid glycophorin antigens. Figure A summarizes the number of reports and antibody specificities . Obstetric cases are restricted to patients and their partners of Southeast Asian ancestry.…”

Section: Discussionmentioning

confidence: 99%

“…(A) Worldwide reported HDFN and hemolytic transfusion reaction cases due to alloantibodies recognizing hybrid A/B glycophorins . (B) The prevalence of GP.Mur among Southeast Asian populations …”

Section: Discussionmentioning

confidence: 99%

“…The K (Kell) antigen is consistently represented among antibody screening reagent RBCs, but other low‐frequency antigens are not. Maternal alloimmunization to low‐frequency antigens such as C w , Kp a , and V w can result in severe consequences to the fetus and infant …”

Section: Case Presentationmentioning

confidence: 99%

“…Maternal alloimmunization to low-frequency antigens such as C w , Kp a , and V w can result in severe consequences to the fetus and infant. [3][4][5] The inheritance of some blood group antigens is restricted to certain ethnicities, some of which occur with relatively common frequency. The antigens in the MNS blood group system expressed from hybrid glycophorins A and B (formerly known as the Miltenberger series) are such an example, many of which are prevalent among Southeast Asians.…”

Section: Case Presentationmentioning

confidence: 99%

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Fetal inheritance of GPMur* causing severe HDFN in an unrecognized case of maternal alloimmunization

Mallari

Chan

Powers³

et al. 2020

Transfusion

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BACKGROUND The clinical and laboratory features of hemolytic disease of the newborn can be challenging to diagnose during pregnancy in the apparent absence of a blood group antibody. Low‐frequency antibodies go undetected due to the lack of appropriate antigen‐positive reagent red blood cells (RBCs). CASE REPORT A pregnant woman of Southeast Asian descent was referred to a maternal‐fetal medicine outpatient clinic due to a complicated obstetric history and a negative antibody screen. This initial visit at 29 weeks and 0 days’ gestational age (GA) was unremarkable. A hydropic infant, born at 29 weeks and 5 days’ GA, succumbed on the seventh day of life. Comprehensive laboratory testing was performed after birth. The hospital blood bank performed a maternal antibody identification. Direct antiglobulin test was performed on the cord blood. A reference laboratory confirmed an anti‐Mia, performed paternal Mia phenotyping, and identified a hybrid glycophorin B‐A‐B GP*Mur allele. DISCUSSION Maternal alloimmunization to low‐frequency antigens remains a challenge. Southeast Asians make up a significant percentage in some US locations. Worldwide reports on the frequency of maternal alloimmunization of the MNS system can be used to guide the use of specific reagent RBCs for testing. Such strategies rely on the identification of blood donor units for reagent manufacture and use in perinatal antibody screens. CONCLUSION The incidence of Mia and related antibodies is significant among Southeast Asians. In North America, prenatal antibody screening cells are not routinely chosen to match this population. The clinical and societal implications are discussed.

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