Bir Yenidoğanda Tekrarlayan Intravenöz Immünoglobulin ve Eritrosit Transfüzyonu ile Tedavi Edilen Anti-E, C ve Kell İzoimmünizasyonuna Bağlı Ciddi Hemolitik Hastalık

Year 2022, , 97 - 99, 30.06.2022

Hüsniye Yücel , İstemi Han Çelik , Ayşen Sumru Kavurt , Beyza Özcan , Semih Sandal , Ahmet Yağmur Baş , Nihal Demirel

https://doi.org/10.46969/EZH.1081460

Abstract

Yenidoğanın alloimmün hemolitik hastalığının (YHH) etiyolojisinde Rhesus D dışındaki antikorların önemi giderek artmaktadır. Anti E, c ve Kell antikorlarının birlikte olduğu YHH daha önce bildirilmemiştir. Bu olgu sunumunda ciddi hemolitik hastalık ve sarılık nedeni ile tekrarlayan intravenöz immunoglobulin (İVİG) ve eritrosit transfüzyonu ile tedavi edilen bir vakayı sunmak istedik. Erkek yenidoğana doğumdan sonra 2 ve 3. günde 1 gr/kg IVIG verildi. Eritrosit transfüzyonu 6. günde yapıldı. Postnatal 12. günde hemoliz bulgularının devam etmesi üzerine 3. doz İVİG 1 gr/kg dozunda verildi. Taburculuk sonrası 3. haftada hemoliz bulguları saptanmadı. Sonuç olarak hemoliz, anemi ve sarılık saptanan yenidoğanlarda nadir olsa da birden fazla subgrup uyuşmazlığının olması akla gelmelidir. Fototerapi, İVİG ve eritrosit transfüzyonu tedavi seçenekleri arasındadır.

Keywords

Yenidoğanda izoimmünizasyon, anti-E, anti-c, anti-Kell, İVİG

A Neonate with Severe Hemolytic Disease Treated With Repeated Doses of Intravenous Immunoglobulin and Erythrocyte Transfusion Due to Anti-E, C and Kell Isoimmunization

Abstract

Maternal Ig-G type blood group antibodies other than Rhesus D (RhD) are an increasingly significant cause of alloimmune hemolytic disease of the newborn (HDN). Anti-E, c and Kell associated HDN has not been reported in the literature. We report first case report of this combination with severe hemolytic anemia and hyperbilirubinemia requiring repeated doses of intravenous immunoglobulin (IVIG) and erythrocyte transfusion. He received 1 g/kg IVIG therapy on postnatal day 2 and 3 because of hemolysis. Erythrocyte transfusion was performed on postnatal day 6. Third dose IVIG as 1 gr/kg was given because of ongoing hemolysis on postnatal day 12. Three weeks after discharge he had no hemolysis. In conclusion, isoimmunization due to combination of subgroup incompatibility such as anti-E, c and Kell should be considered in patients with hemolysis, anemia and jaundice although combination of these isoimmunization is rare. Phototherapy, IVIG and erythrocyte transfusion are treatment options.

Keywords

newborn isoimmunization, anti-E, anti-c, anti-Kell, IVIG

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