Enhancement of Antibody Titre and Development of Additional Red Cell Alloantibodies Following Intrauterine Transfusion

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• 作者：Anju Dubey ; Atul Sonker ; Rajendra Chaudhary
• 关键词：Intra uterine transfusion ; Fetomaternal hemorrhage ; Anti ; D ; Antibody titre
• 刊名：Indian Journal of Hematology and Blood Transfusion
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：32
• 期：1
• 页码：92-94
• 全文大小：313 KB
• 参考文献：1.Verduin EP, Schonewille H, Brand A et al (2013) High anti-HLA response in women exposed to intrauterine transfusions for severe alloimmune hemolytic disease is associated with mother–child HLA triplet mismatches, high anti-D titer, and new red blood cell antibody formation. Transfusion 53:939–947CrossRef PubMed
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• 作者单位：Anju Dubey (1)
  Atul Sonker (2)
  Rajendra Chaudhary (2)
  
  1. Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, 249201, India
  2. Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India
  
• 刊物主题：Hematology; Oncology; Blood Transfusion Medicine; Human Genetics;
• 出版者：Springer India
• ISSN：0974-0449

文摘

Intrauterine blood transfusion is the mainstay of managing foetuses with severe anemia. It may however result in fetomaternal hemorrhage, which in cases of Rh isoimmunisation may increase the severity of the disease by enhancing the maternal immunological response to fetal antigens. This study was conducted to determine the frequency, specificity and origin of additional red cell antibodies which developed after IUT. The change in the titre of allo anti-D following IUT was also determined. Antibody detection and titration was done on the blood samples of all the patients before and after intrauterine blood transfusion to check for the development of additional antibody and change in the titre of existing anti-D. Severe anemia was found in 17 (58.6 %) fetuses who received a total of 42 ultrasound-guided IUTs. Development of antibodies additional to anti-D in maternal serum was seen in 5 (29.4 %) cases. The specificity of additional alloantibodies was anti-C in four cases whereas it was anti-E in one case. Four fold or greater increase in existing allo-anti D titre was seen in 6 (35.3 %) cases after IUT. Enhancement of maternal sensitisation leading to an increase in maternal antibody titre is particularly seen after the first IUT. Matching of the donor RBCs particularly for Rh antigens might prevent the induction of additional alloantibodies against these antigens. IUT as a treatment modality should be given judiciously and only when the need is inevitable. Keywords Intra uterine transfusion Fetomaternal hemorrhage Anti-D Antibody titre