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Case report
Severe haemolytic disease of a newborn with variant D mimicking blocked-D phenomenon
  1. Soumya Das1,
  2. Shamee Shastry2 and
  3. Poornima B Baliga2
  1. 1 Clinical Hematology and Medical Oncology, Malabar Cancer Center, Thalassery, Kerala, India
  2. 2 Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
  1. Correspondence to Dr Shamee Shastry; shameeshastry{at}gmail.com

Abstract

Anti-D is still the most common antibody causing severe haemolytic disease of the fetus and newborn (HDFN). In a mother with a very high titer of anti-D, antibodies can coat and block the D antigens on the red blood cells of the newborn. This blocking phenomenon prevents agglutination of the D-positive red cells with the IgM anti-D typing reagent, giving false negative results. Here, we report the case of a newborn with variant D phenotype and severe HDFN, which mimicked the blocked-D phenomenon, which, at the first instance, confused both the treating clinicians and the transfusion service personnel.

  • haematology (incl blood transfusion)
  • obstetrics and gynaecology
  • pregnancy
  • neonatal and paediatric intensive care
  • materno-fetal medicine
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Footnotes

  • Twitter @Shameeshastry

  • Contributors The article has been read and approved by all authors. It is not under active consideration for publication, has not been accepted for publication, nor has it been published, in full or in part. There is no conflict of interest among the authors. The author’s contributions are as follows: SD planned and performed the immunohaematology workup in the study and writing the manuscript. SS planned, guided the study and corrected the manuscript. PBB corrected the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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