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Hemolytic Disease of the Newborn Associated with Anti-Jr(a) Alloimmunization in a Twin Pregnancy: The First Case Report in Korea

Cited 8 time in Web of Science Cited 7 time in Scopus
Authors
Kim, Hyungsuk; Park, Min-Jeong; Choi, Ji Seon; Sung, Tae-Jung; Han, Kyou-Sup; Park, Kyoung Un; Hyun, Jungwon
Issue Date
2010-10
Publisher
KOREAN SOC LABORATORY MEDICINE
Citation
KOREAN JOURNAL OF LABORATORY MEDICINE; Vol.30 5; 511-515
Keywords
Anti-Jr(a)Neonatal jaundiceFetal erythroblastosisHematologic pregnancy complications
Abstract
Jr(a) is a high-frequency antigen found in all ethnic groups. However, the clinical significance of the anti-Jr(a) antibody has remained controversial. Most studies have reported mild hemolytic disease of the newborn and fetus (HDNF) in Jr(a)-positive patients. Recently, fatal cases of HDNF have also been reported. We report the first case of HDNF caused by anti-Jr(a) alloimmunization in twins in Korea. A 33-yr-old nulliparous woman with no history of transfusion or amniocentesis was admitted at the 32nd week of gestation because of vaginal bleeding caused by placenta previa. Anti-Jr(a) antibodies were detected in a routine laboratory examination. An emergency cesarean section was performed at the 34th week of gestation, and 2 premature infant twins were delivered. Laboratory examination showed positive direct antiglobulin test and Jr(a+) phenotype in the red blood cells and the presence of anti-Jr(a) antibodies in the serum in both neonates. The infants underwent phototherapy for neonatal jaundice; this was followed by conservative management. They showed no further complications and were discharged on the 19th postpartum day. Preparative management to ensure the availability of Jr(a-) blood, via autologous donation, and close fetal monitoring must be performed even in cases of first pregnancy in Jr(a-) women. (Korean J Lab Med 2010;30:511-5)
ISSN
1598-6535
Language
English
URI
https://hdl.handle.net/10371/76360
DOI
https://doi.org/10.3343/kjlm.2010.30.5.511
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College of Medicine/School of Medicine (의과대학/대학원)Laboratory Medicine (검사의학전공)Journal Papers (저널논문_검사의학전공)
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