Asian journal of transfusion science · 2025
Hyperbilirubinemia in a glucose-6-phosphate dehydrogenase-deficient newborn: Confounding role of maternal anti-Inb in finding the crossmatch-compatible blood for exchange transfusion.
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Joshi Sanmukh Ratilal, Kanani Ashish, Rajapara Manisha, Dhanani Hiren, Vekariya Mayuri, Radadiya Priya, Patel Saurabh
Аннотация
BACKGROUND: Crossmatch test for neonate transfusion is performed on maternal serum.
AIM: The aim of this study was to investigate whether an alloantibody to a high-frequency antigen (HFA) in the mother may pose a problem in finding compatible blood for transfusion.
MATERIALS AND METHODS: Blood grouping reagent antisera, red cell panel, papain enzyme, and 2-aminoethyl isothiouronium bromide powders were obtained from a local supply and were used according to standard protocol. Clinical details were obtained from the patient's records.
RESULTS: A 5-day-old male with rising serum bilirubin at 24 mg/dL was planned for exchange transfusion. The blood samples of the baby and his mother were referred to get compatible blood. While the baby and his mother both were typed A, RhD+, no blood unit was compatible with mother's serum due to pan-reactive alloantibody against some HFAs. The physician adopted an alternative strategy of phototherapy in combination with Intravenous immunoglobulin (IVIG) as treatment. Meanwhile, the antibodies were identified as anti-Inb reacting at 37°C, which is innocuous with regard to neonatal jaundice. The baby's red blood cells were tested as glucose-6-phosphate dehydrogenase (G6PD) deficient, and he was administered Vitamin K at birth, which explained clinical hemolysis.
CONCLUSION: An alloantibody to an HFA in the mother posed a problem in finding compatible blood for transfusion. Severe hyperbilirubinemia was due to drug-induced hemolysis in the baby with G6PD deficiency and was successfully treated by phototherapy and IVIG.
AIM: The aim of this study was to investigate whether an alloantibody to a high-frequency antigen (HFA) in the mother may pose a problem in finding compatible blood for transfusion.
MATERIALS AND METHODS: Blood grouping reagent antisera, red cell panel, papain enzyme, and 2-aminoethyl isothiouronium bromide powders were obtained from a local supply and were used according to standard protocol. Clinical details were obtained from the patient's records.
RESULTS: A 5-day-old male with rising serum bilirubin at 24 mg/dL was planned for exchange transfusion. The blood samples of the baby and his mother were referred to get compatible blood. While the baby and his mother both were typed A, RhD+, no blood unit was compatible with mother's serum due to pan-reactive alloantibody against some HFAs. The physician adopted an alternative strategy of phototherapy in combination with Intravenous immunoglobulin (IVIG) as treatment. Meanwhile, the antibodies were identified as anti-Inb reacting at 37°C, which is innocuous with regard to neonatal jaundice. The baby's red blood cells were tested as glucose-6-phosphate dehydrogenase (G6PD) deficient, and he was administered Vitamin K at birth, which explained clinical hemolysis.
CONCLUSION: An alloantibody to an HFA in the mother posed a problem in finding compatible blood for transfusion. Severe hyperbilirubinemia was due to drug-induced hemolysis in the baby with G6PD deficiency and was successfully treated by phototherapy and IVIG.