Possible suppression of fetal erythropoiesis by the Kell blood group antibody anti-Kp(a).
Immunohematology
; 27(2): 58-60, 2011.
Article
in En
| MEDLINE
| ID: mdl-22356520
ABSTRACT
Antibodies to antigens in the Kell blood group system are usually immunoglobulin G, and, notoriously, anti-K, anti-k, and anti-Kp(a) can cause severe hemolytic transfusion reactions, as well as severe hemolytic disease of the fetus and newborn (HDFN). It has been shown that the titer of anti-K does not correlate with the severity of HDFN because, in addition to immune destruction of red blood cells (RBCs), anti-K causes suppression of erythropoiesis in the fetus, which can result in severe anemia. We report a case involving anti-Kp(a) in which one twin was anemic and the other was not. Standard hemagglutination and polymerase chain reaction (PCR)-based tests were used. At delivery, anti-Kp(a) was identified in serum from the mother and twin A, and in the eluate prepared from the baby's RBCs. PCR-based assays showed twin A (boy) was KEL*841T/C (KEL*03/KEL*04), which is predicted to encode Kp(a+b+). Twin B (girl) was KEL*841C/C (KEL*04/KEL*04), which is predicted to encode Kp(ab+). We describe the first reported case of probable suppression of erythropoiesis attributable to anti-Kp(a). One twin born to a woman whose serum contained anti-Kp(a) experienced HDFN while the other did not. Based on DNA analysis, the predicted blood type of the affected twin was Kp(a+b+) and that of the unaffected twin was Kp(ab+). The laboratory findings and clinical course of the affected twin were consistent with suppression of erythropoiesis in addition to immune RBC destruction.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Group Incompatibility
/
Erythroblastosis, Fetal
/
Erythrocytes
/
Kell Blood-Group System
/
Antibodies
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Immunohematology
Journal subject:
ALERGIA E IMUNOLOGIA
/
HEMATOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
United States