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.
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Case Report
Anti-E alloimmunization in a pregnancy with a low antibody titer
K. Nakanishi1, Y. Oishi1, T. Miyamoto2,*, E. Nakamura3, K. Murakami1, M. Ono1, A. Nozawa1, S. Kitamura1, K. Sengoku2
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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
*Correspondence: toshim@asahikawa-med.ac.jp (TOSHINOBU MIYAMOTO)
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
Copyright: © 2020 Nakanishi et al. Published by IMR Press.
This is an open access article under the CC BY 4.0 license
http://creativecommons.org/licenses/by/4.0/.
Abstract
Keywords
Alloimmunization
Anti-E antibody
Hemolytic disease of the fetus and newborn
Pregnancy
Rho(D) immunoglobulin.
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