Identification of alloantibody causing hemolytic disease of newborn with multiple maternal IgG antibodies

Authors

  • Wajiha Shujaat Indus Hospital & Health Network Karachi Pakistan
  • Syeda Tabeena Ali Indus Hospital & Health Network Karachi Pakistan https://orcid.org/0009-0008-3499-4273
  • Amjid Hanif Indus Hospital & Health Network Karachi Pakistan

DOI:

https://doi.org/10.59736/IJP.23.02.947

Keywords:

Antibodies, Hemolytic Disease, Maternal Antibodies

Abstract

Introduction: Hemolytic disease of the fetus and newborn (HDFN) results from passage of maternal alloantibodies like anti-Fya (IgG) through placenta. They attach with fetal red blood cells cause hemolysis.  It is a rare but sometimes a serious health concern.

Case Report: A preterm 12-day-old male child was born preterm, presented with a complaint of yellowish discoloration of skin and sclera for 5 days. He weighed 3.2 kg at birth and at the time of hospital admission the weight was 2.6kg. On examination, he was a deeply icteric child, and no active bleeding was observed. CBC showed Hb 16.2 g/dL, TLC 6x109 /L, and platelets 437x109/L. Reticulocyte counts 0.92%, and total bilirubin 19 mg/dL.

Conclusion: It is suggested that once throughout the antenatal care of pregnant women minor blood group antibody screening be performed.

References

Gupta V, Sidhu M, Shah SN. Hemolytic disease of the fetus and newborn due to multiple alloantibodies in pregnancy. Asian J Transfus Sci. 2020; 14(1):83–6. Doi: 10.4103/ajts.AJTS_40_19.

Goodrick MJ, Hadley AG, Poole G. Haemolytic disease of the fetus and newborn due to anti-Fy(a) and the potential clinical value of Duffy genotyping in pregnancies at risk. Transfus Med. 1997; 7(4):301–4. Doi: 10.1046/j.1365-3148.1997.d01-38.x.

Hall V, Vadakekut ES, Avulakunta ID. Hemolytic disease of the fetus and newborn. [Updated 2024 Jun 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557423/

Iberahim S, Aizuddin MJ, Kadir NA, Rameli N, Adzahar S, Noor NHM, et al. Hemolytic disease of fetus and newborn in a primigravida with multiple alloantibodies involving anti-Jka and anti-E: a case report. Oman Med J. 2020 Nov 30; 35(6):e206. Doi: 10.5001/omj.2020.135.

Mbalibulha Y, Natukunda B, Okwi AL, Kalyango JN, Isaac K, Ononge S. Alloimmunization to Rh antigen (D, C, E, C, E) among pregnant women attending antenatal care in South Western Uganda. J Blood Med. 2022 Nov 29; 13:747–52. Doi: 10.2147/JBM.S385737.

Tormey CA, Hendrickson JE. Transfusion-related red blood cell alloantibodies: induction and consequences. Blood. 2019; 133(17):1821–30. Doi: 10.1182/blood-2018-08-833962.

Zheng Y, Li D, Li X, et al. Spontaneous massive fetomaternal hemorrhage: two case reports and a literature review of placental pathology. BMC Pregnancy Childbirth. 2023; 23:530. Doi: 10.1186/s12884-023-05826-9.

Dean L. Blood groups and red cell antigens [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 2005. Chapter 4, Hemolytic disease of the newborn. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2266/

Delaney M, Matthews DC. Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn. Hematology Am Soc Hematol Educ Program. 2015; 2015(1):146–51. Doi: 10.1182/asheducation-2015.1.146.

Agrawal A, Hussain KS, Kumar A. Minor blood group incompatibility due to blood groups other than Rh(D) leading to hemolytic disease of fetus and newborn: a need for routine antibody screening during pregnancy. Intractable Rare Dis Res. 2020; 9:43–7.

Varghese S, Prakash S, Mukherjee S, Sahu A, Mishra D. Hemolytic disease of the fetus and newborn due to minor blood group alloimmunization in a mother of sickle cell disease with multiple alloantibodies. Asian J Transfus Sci. 2023; 17(2):291–4. Doi: 10.4103/ajts.ajts_161_22.

Wu KH, Chu SL, Chang JG, Shih MC, Peng CT. Haemolytic disease of the newborn due to maternal irregular antibodies in the Chinese population in Taiwan. Transfus Med. 2003; 13:311–4.

Lopriore E, Rath ME, Liley H, Smits-Wintjens VE. Improving the management and outcome in haemolytic disease of the foetus and newborn. Blood Transfus. 2013 Oct; 11(4):484–6. Doi: 10.2450/2013.0147-13.

Alford B, Landry BP, Hou S, Bower X, Bueno AM, Chen D, et al. Validation of a non-invasive prenatal test for fetal RhD, C, c, E, K and Fya antigens. Sci Rep. 2023 Aug 7; 13(1):12786. Doi: 10.1038/s41598-023-39283-3.

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Published

2025-07-02

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Section

Case Reports

How to Cite

1.
Shujaat W, Ali ST, Hanif A. Identification of alloantibody causing hemolytic disease of newborn with multiple maternal IgG antibodies. Int J Pathol [Internet]. 2025 Jul. 2 [cited 2025 Jul. 6];23(2):110-3. Available from: https://jpathology.com/index.php/OJS/article/view/947