Severe fetal hemolysis and cholestasis due to high-titer maternal IgG anti-A antibodies

Rens Zonneveld, Laura van der Meer-Kapelle, Marc Sylva, Anneke Brand, Marianne Zijlstra, Henk Schonewille

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Abstract

ABO blood group incompatibility between mother and fetus can lead to hemolytic disease of the fetus and newborn (HDFN). We present the first case of severe O/A HDFN associated with extremely high-titer (1:32 000) immunoglobulin G anti-A antibodies in a Cameroon mother. Cord blood analysis revealed severe fetal hemolytic anemia and conjugated hyperbilirubinemia. After exclusion of an underlying disease and other risk factors, cholestasis resolved after treatment with ursodeoxycholic acid, a red blood cell transfusion, and intravenous immunoglobulins. This case is presented to create awareness for a more severe course of ABO HDFN in nonwhite and non-European mother-child pairs.
Original languageEnglish
Article numbere20182859
JournalPediatrics
Volume143
Issue number4
DOIs
Publication statusPublished - 2019

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