HDN(hemolytic disease of the newborn) is a fetal hemolytic anemia caused by an IgG
antibody transmitted from the mother to the fetus across the placenta. The antibody is
directed against one of the antigens of the fetal red cells. Anti-Rho(D) has been the
most common antibody responsible for HDN, but recently, because of Rho(D) immune
globulin prophylaxis, the incidence of HDN due to Rho(D) has become decreased
whereas HDN due to anti-E and the other antibodies seems to to increased.
The 2days old male baby was admitted because of jaundice and anemia which were
developed at time of birth. Baby's blood type was 0, CcDEe, the mother's A, CCDee,
and the father's B, ccDEE. The mother's serum revealed positive indirect antiglobulin
test, and the antibody in the maternal serum was indentified as anti-E with the reaction
of panel cells including O, CcDEe and O, CcDee.
The baby's red blood cells revealed positive direct antiglobulin test. and
polyagglutination of red cells was found. This polyagglutinability may be resulted from
associating hemolytic anemia, but differential indentification of polyagglutinability cannot
be performed due to lack of baby's blood samples.
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