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Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
HLA-DQB1*0201 phenotype and severe primary RhD immunization
A. Giancotti1, A. Pizzuti2, V. D'Ambrosio1, 2, *, A. De Filippis1, F. Vena1, M. G. Piccioni1, R. D'Amelio1, R. Brunelli1
1 Department of Gynecological, Obstetrical and Urological Sciences, University of Rome "Sapienza", Policlinico Umberto I Hospital, Rome, Italy
2 Department of Experimental Medicine, University of Rome "Sapienza", Policlinico Umberto I Hospital, Rome, Italy
Clin. Exp. Obstet. Gynecol. 2018, 45(4), 549–551; https://doi.org/10.12891/ceog4480.2018
Published: 10 August 2018
Purpose of Investigation: Although post-delivery administration of anti-D immunoglobulin (anti-D Ig) and antenatal prophylaxis the residual prevalence of RH alloimmunization is due to an incomplete application of the guidelines or to clinical conditions that foster mechanisms of immunization. Materials and Methods: The authors report a case of devastating RhD alloimmunization in a secundipara, group 0 Rh negative, without potentially immunizing events. Results: Anti-D antibodies were screened at 6/2 and at 13/4 weeks and were found negative. Fetal echocardiography at 25/0 weeks showed dilated right cardiac sections and a mild pericardial effusion. Titer of anti-D antibodies was (1:1024) with negative Kleihauer-Betke. At 27/0 weeks she had an increase of anti-D antibody titer (1:8192), peak systolic velocity in the middle cerebral artery suggested severe fetal anemia. A positive HLA-DQB1 allele *0201 was found, and she gave birth to an infant with severe immune-mediated hemolysis (HB: 3.8 g/dl) who was discharged 62 days after birth due to perinatal complications. Conclusion: HLA-DQB1*0201 phenotyping can improve the surveillance and treatment of non-sensitized D negative patients.
Anti-D immunoglobulin (anti-D Ig)