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Successful treatment of extremely severe fetal anemia due to anti-Jra alloimmunization.

AbstractBACKGROUND:
Although Jr(a) hemolytic disease of the newborn (HDN) is generally considered to be mild, we encountered a case of anti-Jr(a) alloimmunization hydrops fetalis due to extremely severe fetal anemia that required aggressive intrauterine treatment.
CASE REPORT:
A Japanese woman developed hydrops fetalis at the 29th week of gestation. Blood examination was highly positive for anti-Jr(a) antibodies. Cordocentesis demonstrated that the fetus had anti-Jr(a) antibodies and the lowest fetal hemoglobin concentration was 2.3 g/dl. After a total of four intravascular transfusions, fetal hydrops improved and a healthy girl of 2,120 g was delivered at the 35th week of gestation. The initial neonatal hemoglobin concentration at birth was 7.2 g/dl. After two straight transfusions, the infant's anemia did not worsen. Anti-Jr(a) antibodies became negative without developing hyperbilirubinemia.
CONCLUSION:
The incidence of Jr(a) negativity can lead to underestimation of the risk of Jr(a) alloimmunization. This case shows that anti-Jr(a) alloimmunization may cause HDN and hydrops fetalis.
AuthorsYuki Ishihara, Shigeki Miyata, Yoshihide Chiba, Takeshi Kawai
JournalFetal diagnosis and therapy (Fetal Diagn Ther) Vol. 21 Issue 3 Pg. 269-71 ( 2006) ISSN: 1015-3837 [Print] Switzerland
PMID16601336 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright 2006 S. Karger AG, Basel.
Chemical References
  • Blood Group Antigens
  • Hemoglobins
  • Isoantibodies
Topics
  • Adult
  • Anemia (immunology, therapy)
  • Blood Group Antigens (immunology)
  • Blood Group Incompatibility (complications)
  • Blood Transfusion, Intrauterine
  • Female
  • Fetal Blood (chemistry)
  • Fetal Diseases (immunology, therapy)
  • Gestational Age
  • Hemoglobins (analysis)
  • Humans
  • Hydrops Fetalis (immunology, therapy)
  • Isoantibodies (blood)
  • Pregnancy
  • Pregnancy Outcome

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