Different Types of Minor Blood Group Incompatibility Causing Haemolytic Disease of Neonates in one of the National Children's Medical Centre in China

Mingchun Lin, Meixiu Liu, Shulian Zhang, Chao Chen, Jin Wang, Mingchun Lin, Meixiu Liu, Shulian Zhang, Chao Chen, Jin Wang

Abstract

Purpose: To review the neonatal cases with different types of minor blood group incompatible haemolytic diseases in China, and to improve the clinical understanding and management.

Materials and methods: Seven cases from January, 1st, 2013 to December 31st, 2019 were searched out and reviewed retrospectively. All clinical data and laboratory findings were collected.

Results: There were totally seven cases enrolled including three cases of MNS, three of Diego, and one of Kidd combined with Rh, anti-RhE incompatibility. Among the seven cases, two had intrauterine transfusion, two underwent exchange transfusion, five received intravenous immune globulin, five cases developed anaemia, and three of them had transfusion. But among them, only four were found to have positive antibody screening and three were confirmed HDN with antibody types antenatally.

Conclusion: The clinical presentation is diverse. Antibody screening followed by the technique of peak systolic velocity in the fetal middle cerebral artery (MCA-PSV) helps to filter out the severe cases.

Keywords: Diego blood group; HDN; Kidd blood group; MNS blood group; alloimmunization; neonatal haemolytic disease.

Conflict of interest statement

All the authors have disclosed no conflicts of interest.

© 2021 Lin et al.

References

    1. de Haas M, Thurik FF, Koelewijn JM, van der Schoot CE. Haemolytic disease of the fetus and newborn. Vox Sang. 2015;109(2):99–113. doi:10.1111/vox.12265
    1. Ma X, Chen FZ, Hong Q. [Analysis of screening results in 501 newborns with hemolytic disease]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019;27(1):192–196. Chinese. doi:10.7534/j.issn.1009-2137.2019.01.031
    1. Doyle B, Quigley J, Lambert M, et al. A correlation between severe haemolytic disease of the fetus and newborn and maternal ABO blood group. Transfus Med. 2014;24(4):239–243. doi:10.1111/tme.12132
    1. Herschel M, Karrison T, Wen M, Caldarelli L, Baron B. Isoimmunization is unlikely to be the cause of hemolysis in ABO-incompatible but direct antiglobulin test-negative neonates. Pediatrics. 2002;110(1 Pt 1):127–130.
    1. Rath ME, Smits-Wintjens VE, Lindenburg IT, et al. Postnatal outcome in neonates with severe Rhesus c compared to rhesus D hemolytic disease. Transfusion. 2013;53(7):1580–1585. doi:10.1111/j.1537-2995.2012.03937.x
    1. Tewari VV, Kumar A, Singhal A, et al. Evaluation of Rh-Hemolytic disease in neonates and management with early intensive phototherapy in the neonatal intensive care unit. J Trop Pediatr. 2020;66(1):75–84. doi:10.1093/tropej/fmz033
    1. Altunyurt S, Okyay E, Saatli B, Canbahishov T, Demir N, Ozkan H. Neonatal outcome of fetuses receiving intrauterine transfusion for severe hydrops complicated by Rhesus hemolytic disease. Int J Gynaecol Obstet. 2012;117(2):153–156. doi:10.1016/j.ijgo.2011.12.013
    1. Koelewijn JM, Vrijkotte TG, van der Schoot CE, Bonsel GJ, de Haas M. Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands. Transfusion. 2008;48(5):941–952.
    1. Katsuragi S, Ohto H, Yoshida A, et al. Anemic disease of the newborn with little increase in hemolysis and erythropoiesis due to maternal anti-Jr(a): a Case Study and Review of the Literature. TRANSFUS MED REV. 2019;33(3):183–188. doi:10.1016/j.tmrv.2019.03.002
    1. Gu S, Wang HX, Yang CY, et al. [Clinical analysis of seven cases of rare hemolytic disease of the newborn]. Zhonghua Er Ke Za Zhi. 2018;56(5):369–372. Chinese. doi:10.3760/cma.j.issn.0578-1310.2018.05.012
    1. Wei CT, Al-Hassan FM, Naim N, Knight A, Joshi SR. Prevalence of Diego blood group antigen and the antibody in three ethnic population groups in Klang valley of Malaysia. Asian J Transfus Sci. 2013;7(1):26–28. doi:10.4103/0973-6247.106725
    1. Bakhtary S, Gikas A, Glader B, Andrews J. Anti-Mur as the most likely cause of mild hemolytic disease of the newborn. Transfusion. 2016;56(5):1182–1184. doi:10.1111/trf.13552
    1. Weiner CP, Widness JA. Decreased fetal erythropoiesis and hemolysis in Kell hemolytic anemia. Am J Obstet Gynecol. 1996;174(2):547–551. doi:10.1016/S0002-9378(96)70425-8
    1. Management of hyperbilirubinemia in the newborn infant. 35 or more weeks of gestation. Pediatrics. 2004;114(1):297–316. doi:10.1542/peds.114.1.297
    1. Mari G, Deter RL, Carpenter RL, et al. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative group for Doppler assessment of the blood velocity in anemic fetuses. N Engl J Med. 2000;342(1):9–14. doi:10.1056/NEJM200001063420102
    1. Markham KB, Rossi KQ, Nagaraja HN, O’Shaughnessy RW. Hemolytic disease of the fetus and newborn due to multiple maternal antibodies. Am J Obstet Gynecol. 2015;213(1):61–68. doi:10.1016/j.ajog.2015.01.049
    1. Yang ZYST. The value of antibody screening test during antenatal clinic to prevent HDN. Attachment of one case with anti-M neonatal hemolysis disease. Chin J Immunol. 2017;2(33):278–279.
    1. Christensen RD, Baer VL, MacQueen BC, O’Brien EA, Ilstrup SJ. ABO hemolytic disease of the fetus and newborn: thirteen years of data after implementing a universal bilirubin screening and management program. J PERINATOL. 2018;38(5):517–525. doi:10.1038/s41372-018-0048-4
    1. Louis D, More K, Oberoi S, Shah PS. Intravenous immunoglobulin in isoimmune haemolytic disease of newborn: an updated systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2014;99(4):F325–31. doi:10.1136/archdischild-2013-304878
    1. Christensen RD, Yaish HM. Hemolysis in preterm neonates. Clin Perinatol. 2016;43(2):233–240. doi:10.1016/j.clp.2016.01.002
    1. Moise KJ. Non-anti-D antibodies in red-cell alloimmunization. Eur J Obstet Gynecol Reprod Biol. 2000;92(1):75–81. doi:10.1016/S0301-2115(00)00428-0
    1. Lee CK, Ma ES, Tang M, Lam CC, Lin CK, Chan LC. Prevalence and specificity of clinically significant red cell alloantibodies in Chinese women during pregnancy–a review of cases from 1997 to 2001. Transfus Med. 2003;13(4):227–231. doi:10.1046/j.1365-3148.2003.00445.x
    1. Castilho L. An update on the MNS blood group system. Immunohematology. 2019;35(2):61–62. doi:10.21307/immunohematology-2020-014
    1. Slootweg YM, Walg C, Koelewijn JM, Van Kamp IL, De Haas M. Knowledge, attitude and practices of obstetric care providers towards maternal red-blood-cell immunization during pregnancy. Vox Sang. 2020;115(3):211–220. doi:10.1111/vox.12883
    1. Reid ME. MNS blood group system: a review. Immunohematology. 2009;25(3):95–101.
    1. De Young-owens A, Kennedy M, Rose RL, Boyle J, O’Shaughnessy R. Anti-M isoimmunization: management and outcome at the Ohio State University from 1969 to 1995. Obstet Gynecol. 1997;90(6):962–966. doi:10.1016/S0029-7844(97)00476-6
    1. Hassan MN, Mohd NN, Johan NS, Sukri SA, Mustafa R, Luc AH. Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population. Asian J Transfus Sci. 2014;8(2):113–117. doi:10.4103/0973-6247.137449
    1. Li S, Mo C, Huang L, et al. Hemolytic disease of the fetus and newborn due to alloanti-M: three Chinese case reports and a review of the literature. Transfusion. 2019;59(1):385–395. doi:10.1111/trf.15054
    1. Stetson B, Scrape S, Markham KB. Anti-M alloimmunization: management and outcome at a single institution. AJP Rep. 2017;7(4):e205–10. doi:10.1055/s-0037-1607028
    1. Mohd NH, Noor HM, Shafini MY, Noor SAA, Rapiaah M, Wan ZA. Anti-M induced severe haemolytic disease of foetus and newborn in a Malay woman with recurrent pregnancy loss. Malays J Pathol. 2017;39(1):73–76.
    1. Yasuda H, Ohto H, Nollet KE, et al. Hemolytic disease of the fetus and newborn with late-onset anemia due to anti-M: a case report and review of the Japanese literature. Transfus Med Rev. 2014;28(1):1–6. doi:10.1016/j.tmrv.2013.10.002
    1. Gao XY, Huang H, Li LD. [Hemolytic disease of neonates due to anti-M: report of one case and review of reports of 21 cases]. Zhonghua Er Ke Za Zhi. 2009;47(9):648–652. Chinese.
    1. Arora S, Doda V, Maria A, Kotwal U, Goyal S. Maternal anti-M induced hemolytic disease of newborn followed by prolonged anemia in newborn twins. Asian J Transfus Sci. 2015;9(1):98–101. doi:10.4103/0973-6247.150968
    1. Wikman A, Edner A, Gryfelt G, Jonsson B, Henter JI. Fetal hemolytic anemia and intrauterine death caused by anti-M immunization. Transfusion. 2007;47(5):911–917. doi:10.1111/j.1537-2995.2007.01209.x
    1. Lenkiewicz B, Zupanska B. The first example of anti-Diego(b) found in a Polish woman with the Di(a+b-) phenotype and haemolytic disease of the newborn not requiring treatment. Transfus Med. 2003;13(3):161–163. doi:10.1046/j.1365-3148.2003.00437.x
    1. Oh EJ, Jekarl DW, Jang HS, et al. Severe hemolytic disease of the newborn due to anti-Di b treated with phototherapy and intravenous immunoglobulin. Ann Clin Lab Sci. 2008;38(1):80–82.
    1. Hamilton JR. Kidd blood group system: a review. Immunohematology. 2015;31(1):29–35.
    1. Lawicki S, Covin RB, Powers AA. The Kidd (JK) Blood Group System. Transfus Med Rev. 2017;31(3):165–172. doi:10.1016/j.tmrv.2016.10.003

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