IMR Press / CEOG / Volume 47 / Issue 4 / DOI: 10.31083/j.ceog.2020.04.4267
Open Access Case Report
Anti-E alloimmunization in a pregnancy with a low antibody titer
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1 Department of Obstetrics and Gynecology, Nayoro City General Hospital, Nayoro, Japan
2 Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
3 Department of Pediatrics, Nayoro City General Hospital, Nayoro, Japan
Clin. Exp. Obstet. Gynecol. 2020, 47(4), 614–616; https://doi.org/10.31083/j.ceog.2020.04.4267
Submitted: 29 March 2017 | Accepted: 31 May 2017 | Published: 15 August 2020
Abstract

Red blood cell alloimmunization during pregnancy causes hemolytic disease of the fetus and newborn. While alloimmunization in pregnancy is treatable with anti-D antibodies, management with other antibodies has not been studied. A 32-year-old woman had anti-E antibodies detected during pregnancy, but the titer was < 1 : 2. Her newborn was admitted to hospital because direct Coombs tests were positive. Low titers of maternal anti-E antibodies were found in the newborn. We performed phototherapy and administered intravenous immunoglobulin because the newborn showed early jaundice and hyperkalemia, which suggested hemolytic disease. After being discharged at 6 days of age, the baby was readmitted to hospital at 9 days because of recurrent jaundice and underwent phototherapy. The baby was later discharged without recurrence of jaundice. Low anti-E antibody titers in pregnancy can cause alloimmunization, which can be treated successfully. The potential risk of hemolytic disease should be considered in cases with such low titers.

Keywords
Alloimmunization
Anti-E antibody
Hemolytic disease of the fetus and newborn
Pregnancy
Rho(D) immunoglobulin.
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