Korean J Blood Transfus.  2007 Apr;18(1):61-65.

A Case of D--/D-- Phenotype Associated with Moderate Hemolytic Disease of the Newborn

• Um TH
• Cho CR
• Whang JH
• Whang DH
• Yoon MS
• Han KS

Abstract

The very rare D--/D-- phenotype lacks C, c, E, e antigens with strong expression of the D antigen. A 31-year-old woman delivered her second baby, 3.6 kg girl at 38+4 weeks' gestation through repeat-Cesarean section. Her parents were not consanguineous. She had one artificial abortion, one Cesarean section with red blood cell transfusion and two spontaneous abortions. Her red cells were typed as O, D+C-c-E-e- and did not react with anti-Hr(o) (Rh 17). Her serum reacted with all of the screening cells and identification panel cells with strength of (++)~(+++). The baby was mildly jaundiced 12 hours after delivery. At 1 day after delivery, total bilirubin was 17.7 mg/dL, and direct and indirect antiglobulin tests were both positive. Phototherapy was immediately given for the baby but jaundice and anemia were worsened. Twenty six milliliter of the mother's whole blood was given twice to the baby after plasma depletion and leukocyte reduction. The baby showed improvement of jaundice and anemia, and discharged at hospital day 14. As far as we know, this is the third reported case of hemolytic disease of the newborn occurred in the D--/D-- mother with anti-Hr(o) in Korea, and the first case that was neither fatal nor treated with intensive medical care.

Keyword

D--/D-- phenotype; Hemolytic disease of the newborn (HDN); Anti-Hr(o)

MeSH Terms

Abortion, Spontaneous
Adult
Anemia
Bilirubin
Cesarean Section
Coombs Test
Erythrocyte Transfusion
Female
Hepatitis B e Antigens
Humans
Infant, Newborn*
Jaundice
Korea
Leukocytes
Mass Screening
Mothers
Parents
Phenotype*
Phototherapy
Plasma
Pregnancy
Bilirubin
Hepatitis B e Antigens