A challenging case of hemolytic disease of the fetus and newborn (HDFN) due to anti-Ku in a K 0 (Kell null ) mother.

Autor: Wan Mohd Hasni SA; 1National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia., Ahmad NH; 1National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia., Ganeshan M; 2Department of Obstetrics and Gynaecology, Hospital Tunku Azizah, Kuala Lumpur, Malaysia., Yong SL; 2Department of Obstetrics and Gynaecology, Hospital Tunku Azizah, Kuala Lumpur, Malaysia., Tan PP; 3Department of Pathology, Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia., Wahab RA; 4Department of Transfusion Medicine, Hospital Raja Perempuan Zainab II, Jalan Hospital, Kelantan, Malaysia., Musa RH; 1National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia., Muniandi G; 1National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia., Nakulan A; 1National Immunohematology Reference Laboratory, National Blood Centre, Kuala Lumpur, Malaysia., Hassan A; 5Laboratory and Blood Services Department, National Heart Institute, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Immunohematology [Immunohematology] 2024 Oct 04; Vol. 40 (3), pp. 122-127. Date of Electronic Publication: 2024 Oct 04 (Print Publication: 2024).
DOI: 10.2478/immunohematology-2024-016
Abstrakt: Hemolytic disease of the fetus and newborn (HDFN) due to an antibody in the Kell blood group system can be associated with severe fetal anemia. This case report details the challenges of managing a Kell null mother with anti-Ku that affected her fetus/newborn. A gravida 4 para 3 woman at term underwent an emergency lower caesarean section because of fetal distress. The baby was intubated because of low oxygen saturation. An urgent request for a hematology workup showed severe anemia and erythroblastosis fetalis. Unfortunately, no compatible blood was found, and the baby died. The case was referred to the National Blood Centre, and anti-Ku was confirmed in a sample sent from the mother. When she presented with her fifth pregnancy, meticulous planning was used to manage this pregnancy. Her family screening revealed one brother with a matching phenotype. Three blood donations were planned for the brother-for freezing, for intrauterine transfusion, and for standby during delivery. Serial anti-Ku titrations of maternal samples were performed, and the fetus was monitored for anemia through middle cerebral artery Doppler scans. Although the anti-Ku titers reached as high as 1024, fetal anemia was never diagnosed. The neonate was delivered safely but was diagnosed with severe pathologic jaundice and anemia secondary to HDFN and congenital pneumonia. The baby was transfused with K 0 packed red blood cells and later discharged to home.
(© 2024 Siti A. Wan Mohd Hasni et al., published by Sciendo.)
Databáze: MEDLINE
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