Document Detail


Hemolytic disease of the newborn associated with anti-Jra alloimmunization in a twin pregnancy: the first case report in Korea.
MedLine Citation:
PMID:  20890084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Hyungsuk Kim; Min-Jeong Park; Tae-Jung Sung; Ji Seon Choi; Jungwon Hyun; Kyoung Un Park; Kyou-Sup Han
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Korean journal of laboratory medicine     Volume:  30     ISSN:  1598-6535     ISO Abbreviation:  Korean J Lab Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-17     Revised Date:  2014-05-30    
Medline Journal Info:
Nlm Unique ID:  101322822     Medline TA:  Korean J Lab Med     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  511-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Group Antigens / immunology
Blood Group Incompatibility*
Diseases in Twins / diagnosis,  immunology*
Erythroblastosis, Fetal / diagnosis*,  immunology
Female
Gestational Age
Humans
Infant, Newborn
Isoantigens / immunology
Jaundice, Neonatal / complications,  immunology,  therapy
Male
Phenotype
Phototherapy
Pregnancy
Pregnancy Complications, Hematologic / diagnosis,  immunology*
Twins
Chemical
Reg. No./Substance:
0/Blood Group Antigens; 0/Isoantigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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