Document Detail

Platelet transfusion in an infant leading to formation of anti-D: implications for immunoprophylaxis.
MedLine Citation:
PMID:  15104657     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The immature infant immune system rarely makes RBC alloantibodies; however, most studies confirming the absence of alloantibodies in infants have involved transfusions that were matched for one of the most immunogenic antigens, rhesus D. The potential for D- infants to develop anti-D is unknown. Specifically, this issue has not been analyzed for infants receiving whole-blood-derived PLTs from D+ donors. The importance of understanding such risk is underscored by the fact that anti-D formation can be prevented by the administration of Rh immunoglobulin. CASE REPORT: A D- infant with congenital heart disease received two D-mismatched whole-blood-derived PLT units at 17 weeks of age. He did not receive Rh immunoglobulin prophylaxis. Upon a subsequent admission 13 months later, anti-D was identified in his plasma sample. CONCLUSION: The case presented here demonstrates that a young infant can respond to less than 0.6 mL of D+ RBCs and documents the youngest patient to have developed a RBC alloantibody from a PLT transfusion. To prevent anti-D formation, we recommend administering Rh immunoglobulin to all D- pediatric patients that receive PLT transfusions from D+ donors [correction].
Richard L Haspel; Lorna Walsh; Steven R Sloan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transfusion     Volume:  44     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-23     Completed Date:  2004-06-02     Revised Date:  2005-04-12    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  747-9     Citation Subset:  IM    
Pathology Department, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Infant, Newborn
Isoantibodies / biosynthesis*
Platelet Transfusion*
Rho(D) Immune Globulin / immunology*
Reg. No./Substance:
0/Isoantibodies; 0/RHO(D) antibody; 0/Rho(D) Immune Globulin
Comment In:
Transfusion. 2005 Mar;45(3):453; author reply 453-4   [PMID:  15752167 ]
Erratum In:
Transfusion. 2004 Aug;44(8):1270

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

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