The Kidd
blood group is clinically significant since the Jk
antibodies can cause acute and delayed
transfusion reactions as well as
hemolytic disease of newborn (HDN). In general, HDN due to anti-Jk(b) incompatibility is rare and it usually displays mild clinical symptoms with a favorable prognosis. Yet, we apparently experienced the second case of HDN due to anti-Jk(b) with severe clinical symptoms and a fatal outcome. A female patient having the AB, Rh(D)-positive blood type was admitted for
jaundice on the fourth day after birth. At the time of admission, the patient was lethargic and exhibited high pitched crying. The laboratory data indicated a
hemoglobin value of 11.4 mg/dL, a reticulocyte count of 14.9% and a total
bilirubin of 46.1 mg/dL, a direct
bilirubin of 1.1 mg/dL and a strong positive result (+++) on the direct Coomb's test. As a result of the identification of irregular antibody from the maternal serum, anti-Jk(b) was detected, which was also found in the eluate made from infant's blood. Despite the aggressive treatment with exchange transfusion and intensive
phototherapy, the patient died of intractable seizure and
acute renal failure on the fourth day of admission. Therefore, pediatricians should be aware of the clinical courses of
hemolytic jaundice due to anti-Jk(b), and they should be ready to treat this disease with active therapeutic interventions.