A case of severe hemolytic disease of the fetus and the newborn caused by M/N incompatibility

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  • Keida Yumi
    Department of Neonatology, Maternal and Perinatal Care Center, Oita Prefectural Hospital
  • Nakashima Misaki
    Department of Neonatology, Maternal and Perinatal Care Center, Oita Prefectural Hospital
  • Yonemoto Hiroki
    Department of Neonatology, Maternal and Perinatal Care Center, Oita Prefectural Hospital
  • Akaishi Mutsumi
    Department of Neonatology, Maternal and Perinatal Care Center, Oita Prefectural Hospital
  • Iida Koichi
    Department of Neonatology, Maternal and Perinatal Care Center, Oita Prefectural Hospital

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Other Title
  • MN式血液型不適合による重症胎児新生児溶血性疾患の一例

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<p> Hemolytic disease of the fetus and the newborn（HDFN）is caused by the destruction of fetal or neonatal red blood cells through maternal IgG antibodies. Most of anti-M are of the IgM type. However, especially in the Asian population, it has been reported that when a mother has IgG anti-M, they cross the placenta and suppress erythropoiesis of the fetus and the newborn, resulting in severe HDFN. A 3,207g male infant was born at 36weeks and 2days of gestation by cesarean section. He had severe anemia with positive indirect antiglobulin test, and positive elution test. IgG anti-M antibodies were identified, and he was diagnosed with HDFN due to anti-M antibodies. His anemia improved with partial exchange transfusion and red blood cell transfusion. But the anemia progressed gradually and it took more than 2 months for recovering of late anemia. If anti-M antibodies are detected with mother, she should be managed in a higher perinatal facility for evaluating of fetal anemia, and managing of the infant.</p>

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