SIX CASES OF HEMOLYTIC DISEASE OF THE NEWBORN CAUSED BY ANTI-RH ANTIBODIES

• Published in: Japanese Journal of National Medical Services Vol. 48; no. 8; pp. 622 - 625
• Main Authors: NOMURA, Toyoki, OHTA, Takuya, ADACHI, Motoi, INABA, Hiroto, YAMAMOTO, Hatsumi, TAKI, Michio
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1994
• Subjects: D-isoimmunization; E+c-isoimmunization; E-isoimmunization; hemolytic disease of the newborn; Rh-isoimmunization
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.48.622

In the last seven years, we observed six cases of hemolytic disease of the newborn (HDN), two of which were caused by anti-RhD (group RhD); three by anti-RhE and anti-Rhc; and one by anti-RhE. All six infants had hyperbilirubinemia that improved after a single exchange transfusion at zero to four days of age. However, there were a few differences between the infants with HDN induced by anti-RhE or anti-Rhc (group RhE/c) and group RhD. (1) A diagnosis was made later in group RhE/c than in group RhD (three to five days of age vs, zero days of age). (2) On admission, the red blood cell count of group RhE/c was lower than that of group RhD (332±98×104/mm3 vs. 402±34×10/4/mm3), while total bilirubin was higher (22.7±2.0 mg/dl vs. 6.7±6.4 mg/dl). Since 1973, the incidence of HDN caused by anti-RhD has decreased because of the use of antiRhD immunoglobulin; however, the number of cases of HDN due to anti-RhE and/or antiRhc has increased. For the early diagnosis and early therapy of HDN caused by antiRh, we recommend performing an indirect Coombs test in all pregnant women.