Erythrocyte alloimmunization in pregnant women, clinical importance and laboratory diagnostics

Czech version

Authors: I. Holusková ¹; M. Lubušký ^2,3; M. Studničková ² ; M. Procházka ²
Authors‘ workplace: Transfuzní oddělení FN a LF UP, Olomouc, primářka MUDr. D. Galuszková, MBA, Ph. D. ¹; Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. ²; Ústav lékařské genetiky a fetální medicíny FN a LF UP, Olomouc, přednosta prof. MUDr. J. Šantavý, CSc. ³
Published in: Ceska Gynekol 2013; 78(1): 89-99

Overview

Objective:
The aim of this review is to give comprehensive summary of erythrocyte alloimunization of pregnant women, laboratory dignostics and clinical importance.

Design:
Review.

Setting:
University Hospital Olomouc, Transfusion Department, Department of Obstetrics and Gynecology.

Subject and method:
Based on literature analysis using database search engines PubMed, Google Scholar, Ovid in field of erythrocyte antibodies, laboratory diagnostics and clinical importance up-to-date knowledge.

Conclusion:
Erythrocyte alloimunization anti-D antibodies decreases in connection with the introduction of immunoprofylaxis. Immunization of non RhD antibodies with impossibility using of immunoprofylaxis remains still clinical problem.

Keywords:
alloimmunization – anti-D antibodies – prenatal diagnosis

Sources

1. ACOG – American College of Obstetricians and Gynecologists. ACOG Practise Bulletin No 75: management of alloimmunization. Obstet Gynecol, 2006, 108, p. 457–464.

2. Ahaded, A. Brossard, Y., Debbia, M., Lambin, P. Quantitative determination of anti-K (KELL 1) IgG and IgG subclasses in the serum of severely alloimmunized pregnant women by ELISA. Transfusion, 2000, 40, p. 239–1245.

3. Alves de Lima, LM., Berthier, ME., Sad, WE., et al. Characterization of an anti-Dia antibody causing hemolytic disease in a newborn infant. Transfusion, 1982, 22, p. 246–247.

4. Avent, ND. The Rhesus blood group systém: insights from recent advances in molecular biology. Transfus Med Rev, 1999, 13, p. 245–266.

5. Avent, N., Finning, K., Martin, P., Soothill, P. Prenatal determination of fetal blood group status. Vox Sang, 2000, 78 (Suppl. 2), p. 155–162.

6. Babinszki, A., Berkowitz, RL. Haemolytic disease of the newborn caused by anti-c, anti-E and anti-Fya antibodies: report of five cases. Prenat Diagn, 1999, 19, p. 533–536.

7. Berghella, V. Maternal-Fetal Evidence-Based Guidelines (Series in Maternal-Fetal Medicine). Informa-Healthcare Publishing, 1st. ed. 2007.

8. Bowell, PJ., Brown, SE., Dike, AE., Inskip, MJ. The significance of anti-c alloimmunization in pregnancy. Br J Obstet Gynaecol, 1986, 93, 10, p. 1044–1048.

9. Bowman, JM., Harman, CR., Manning, FA., Pollock, JM. Erythroblastosis fetalis produced by anti-k. Vox Sang,1989, 56, 3, p. 187–189, Erratum in: Vo. Sang, 1990, 58, 2, p. 139.

10. Bowman, JM., Pollock, JM., Manning, FA., Harman, CR. Severe anti-C hemolytic disease of the newborn. Am J Obstet Gynecol, 1992, 166, 4, p. 1239–1243.

11. Bowman, JM., Pollock, JM. Maternal Cw alloimmunization. Vox Sang, 1993, 63, p. 226–230.

12. Calda, P. Příčiny, prevence a diagnostika aloimunizace v těhotenství. Actual Gyn, 2009, 1, s. 55–60.

13. Collinet, P., Subtil, D., Puech, F., Vaast, P. Successful treatment of extremely severe fetal anemia due to Kell alloimmunization. Obstet Gynecol, 2002, 100, p. 1102–1105.

14. Contreras, M. The prevention of Rh haemolytic disease of the fetus and newborn-general background. Br J Obstet Gynaecol, 1989, 105, p. 7–10.

15. Costemagna, L., Barbarini, M., Viarengo, GL., et al.A case of hemolytic disease of the newborn due to anti-Kpa. Immunohematol, 1997, 13, p. 61–62.

16. Čermáková, Z., Kořístka, M., Malušková, A. Imunohemato-logie. Ostrava: Ostravská Univerzita v Ostravě, 2008.

17. Dacus, JV., Spinnato, JA. Severe erythroblastosis fetalis secondary to anti-Kpb sensitization, Am J Obstet Gynecol, 1984, 150, p. 888–889.

18. Daniels, G. Human blood groups. Oxford: Blackwell Science, 1995.

19. Daniels, G. Human blood groups. 2nd ed. Oxford: Blackwell Publishing, 2002.

20. Daniels, G., Bromilow, I. Essential Guide to Blood Groups. 1th ed. Oxford: Blackwell Publishing, 2007.

21. Daniels, G., Green, C. Expression of red cell surface antigens during erythropoesis. Vox Sang, 2000, 78 (Suppl. 2), p. 149–153.

22. Daniels, G., Hadley, A., Green, C. Fetal anemia due to anti-K may result from immune destruction of early erythroid progenitors. Transfus Med, 1999, 9 (suppl. 1), p. 16 (abstract).

23. Davie, MJ., Smith, DS., White, UM., Dyball, D. An example of anti-s causing mild haemolytic disease of the newborn. J Clin Pathol, 1972, 25, 9, p. 772–773.

24. Dean, L. Blood Groups and Red Cell Antigens. National Center for Biotechnology Information (US), 2005 NCBI.

25. De Silva, M. New guidelines for pre and perinatal immunohaematology. ISBT, 2003, Istanbul, p. 109–111.

26. Donato, E., Guinot, M., Vilar, C., et al. rHuEPO in the management of pregnancy complicated by anti-Dib. Transfusion, 2003, 43, p. 681–682.

27. Drabik-Clary, K., Reddy, VV., Benjamin, WH., Boctor, FN. Severe hemolytic disease of the newborn in a group B African-American infant delivered by a group 0 mother. Ann Clin Lab Sci, 2006, 36, p. 205–207.

28. Duguid, J., Bromilow I. Haemolytic disease of the newborn due to anti-k. Vox Sang, 1990, 58, 1, p. 69.

29. Duguid, J., Bromilow I., Entwistle, G., Wilkinson, R. Haemolytic disease of the newborn due to anti-M. Vox Sang, 1995, 68, 3, p. 195–196.

30. Dušková, D., Kubánková, H., Masopust, J., et al. Imuno-hematologická vyšetření v těhotenství a po porodu. Doporučení společnosti pro transfuzní lékařství ČLS JEP, č. STL2010_06 ze dne1. 3. 2010 verze 3 (2010_06), Souhrn doporučení.

31. Eckstein, R. Imunohematologie a Transfuzní lékařství, 1. vyd. 1994.

32. Feldman, R., Luhby, AL., Gromisch, DS. Erythroblastosis fetalis due to anti-S antibody. Pediatr, 1973, 82, 1, p. 88–91.

33. Fernandez-Jimenez, MC., Jimenez-Marco, MT., Hernandez, D., et al. Treatment with plasmapheresis and intravenous immunoglobulin in pregnancies complicated with anti PP1Pk or anti-K immunization: a report of two patients. Vox Sang, 2001, 80, p. 117–120.

34. Flegel, W., Wagner, FF., Muller, TH., Gassner, C. Rh phenotype prediction by DNA typik and its application to practice. Transfus Med, 1998, 8, p. 281–302.

35. Furukawa, K., Nakajima, T., Kogure, T., et al. Example of a woman with multiple intrauterine deaths due to anti-M who delivered a live child after plasmaferesis. Exp Clin Immunogenet, 1993, 10, 3, p. 161–167.

36. Geifman-Holtzman, O., Wojtowycz, M., Kosmas, E., Artal, R. Female alloimmunization with antibodies known to cause hemolytic disease. Obstet Gynecol, 1997, 89, 2, p. 272–275.

37. Giblett, E., Chase, J., Crealock, FW. Hemolytic disease of the newborn resulting from anti-s antibody: report of a fatal case resulting from the fourth example of anti-s antibody. Am J Clin Pathol, 1958, 29, 3, p. 254–256.

38. Gooch, A., Parker, J., Wray, J., Qureshi, H. Guideline for blood grouping and antipody testing in pregnancy. British Committee for Standards in Haematology, 2006, www. Bcshguidelines.com.

39. Goodrick, M., Hadley, A., Poole, G. Haemolytic disease of the fetus and newborn due tu anti-Fya and the potential clinical value of Duffy genotyping in pregnancies at risk. Transfus Med, 1997, 7, p. 301–304.

40. Gordon, MC., Kennedy, MS., O’Shaughnessy, RW.,Waheed, A. Severe hemolytic disease of the newborn due toanti-Jsb. Vox Sang, 1995, 69, p. 140–141.

41. Hackney, DN., Knudtson, EJ., Rossi, KQ., et al. Management of pregnancies complicated by anti-c isoimmunization. Obstet Gynecol, 2004, 103, 1, p. 24–30.

42. Hadley, AG., Poole, GD., Poole, J. Haemolytic disease of the newborn due to anti-G. Vox Sang, 1996, 71, p. 108–112.

43. Hadley, A., Soothill, P. Alloimmune disorders of pregnancy: anaemia, trombocytopenia and neutropenia in the fetus and newborn. Cambridge: Cambridge University Press, 2008.

44. Hall, AR., Mason, RP., Mallaband, A. Survey of significant antibodies found in enzyme screen positive but antiglobulin test negative antenatal referrals. Transfus Med, 1997, 7 (Suppl. 1), p. 23.

45. Huber, AR., Leonard, GT., Diggers, RW., et al. Case report: moderate hemolytic disease of the newborn due to anti-G. Immunohematol, 2006, 22, p. 166–170.

46. Hundrič-Haspl, Z., Jurakovič-Loncar, N., Grgicevič, D. Evaluation of the enzyme test for detection of clinically significant red blood cell antibodies during pregnancy. Acta Med Croatica, 1999, 53, p. 125–128.

47. Joy, SD., Rossi, KQ., Krugh, D., O’Shaughnessy, RW. Management of pregnancies complicated by anti-E alloimmunization. Obstet Gynecol, 2005, 105, 1, p. 24–28.

48. Judd, W., Luban, N., Ness, P., et al. Prenatal and perinatal imunohematology: recommendations for serologic management of the fetus, newborn infant, and obstetric patient. Transfusion, 1990, 30, p. 175–183.

49. Judd, WJ. Practice guidelines for prenatal and perinatal imunohematology, revisited. Transfusion, 2001, 41, p. 1445–1452.

50. Kanra, T., Yüce, K., Ozcebe, IU. Hydrops fetalis and intrauterine deaths due to anti-M. Acta Obstet Gynecol Scand, 1996, 775, 4, p. 415–417.

51. Kim, WD., Lee, YH. A fatal case of severe haemolytic disease of newborn associated with anti-Jk(b). J Korean Med Sci, 2006, 21, 1, p. 151–154.

52. Klein, H., Anstee, D. Haemolytic disease of the fetus and newborn. In Mollison’s blood transfusion in clinical medicine. 11th ed. Oxford: Blackwell Publishing, 2005, p. 496–545.

53. Kulich, V., Kohout, M. Hemolytic disease of a newborn caused by anti-k antibody. Ces Pediatr, 1967, 22, 9, p. 823–826.

54. Kusnierz-Alejska, G., Bochenek, S. Haemolytic disease of the newborn due to anti-Dia and incidence of the Dia antigen in Poland. Vox San, 1992, 62, p. 124–126.

55. Lenkiewicz, B., Zupanska, B. The first example of anti-Diego(b) found in a Polish woman with the Di(a+b-) phenotype and haemolytic disease of the newborn not requiring treatment. Transfus Med, 2003, 13, p. 161–163.

56. Levene, C., Rudolphson, Y., Schechter, Y. A second case of hemolytic disease of the newborn due to anti-Jsa. Transfusion, 1980, 20, p. 714–715.

57. Levine, P., Backer, M., Wigod, M., Ponder, R. A new human hereditary blood property (Cellano) present in 99.8% of all bloods.Science, 1949, 6, 109, 2836, p. 464–466.

58. Levine, P., Ferraro, LR., Koch, E. Hemolytic disease of the newborn due to anti-S: a case report with a review of 12 anti-S sera cited in the literature. Blood, 1952, 7, 10, p. 1030–1037.

59. Lubusky, M., Dhaifalah, I., Holuskova, I., et al. The incidence of erytrocyte alloimmunization in pregnant women. Int J Gynaecol Obstet, 2009, 107, S2, p. 439.

60. Lubusky, M., Holuskova, I., Prochazka, M., et al. The incidence of erythrocyte alloimmunization in pregnant women. J Matern Fetal Neonatal Med, 2010, 23 (Suppl. 1), p. 593.

61. Ľubušký, M., Procházka, M. Erytrocytární aloimunizace těhotných žen: Hemolytická nemoc plodu a novorozence. Postgradual Med, 2012, 14, 3, p. 242–246.

62. Macpherson, CR., Zartman, ER. Anti-M antibody as a cause of intrauterine death: a follow up. Am J Clin Pathol, 1965, 43, p. 544–547.

63. Manning, FA. Fetal medicine: principles and practice. Norwalk, Connecticut: Appleton & Lange, 1995.

64. Marshall, CS., Dwyre, D., Eckert, R., Russell, L. Severe hemolytic reaction due to anti-Jk3, Arch Pathol Lab Med, 1999, 123, p. 949–951.

65. Martinez, S., Luna, I., Arriaga, F., et al. Foetus fatal haemolytic disease by anti-Jkb, a case report. Vox Sang, 2007, 93 (Suppl. 1), p. 8.

66. Masopust, J. Hemolytická nemoc novorozenců – význam kritického titru antierytrocytárních protilátek. Neonat Listy, 1998, s. 18–21.

67. Matsumoto, H., Tamaki, Y., Sato, S., Shibata, K. A case of hemolytic disease of the newborn caused by anti-M: serological study of maternal blood. Acta Obstet Gynaecol Jpn, 1981, 33, 4, p. 525–528.

68. Mayne, K., Bowell, P., Woodward, T., et al. Rh immunization by the partial D antigen of category DVa. B J Haematol, 1989, 76, p. 537–539.

69. Mayne, K., Bowell, P., Green, S., Entwistle, C. The significance of anti-S sensitization in pregnancy. Clin Lab Haematol, 1990, 12, 1, p. 105–107.

70. McKenna, DS., Nagaraja, HN., O’Shaughnessy, RW. Management of pregnancies complicated by anti-Kell isoimmunization. Obstet Gynecol, 1999, 93, p. 667–673.

71. Moise, K. Non anti-D antibodies in red cell alloimmunization. Eur J Obstet Gynecol Reprod Biol, 2000, 92, p. 75–81.

72. Moise, K. Red blood cell alloimmunization in pregnancy. Seminars in Hematology, 2005, p. 169–178.

73. Moise, K. Fetal anemia due to non-Rhesus-D red-cell alloimmunization. Semin Fetal Neonatal Med, 2008, 13, 4, p. 207–214.

74. Moise, K. Kell aloimunizace matky může vést k rozvoji anémie plodu. Gynek po promoci. 2009, s. 24–31.

75. Mollison, PL., Engelfriet, CP., Contreras, M. Blood transfusion in clinical medicine. 10th ed. Oxford: Blackwell Science, 1997.

76. Moran, P., Robson, S., Reid, M. Anti-E in pregnancy. Brit J Obstet Gynecol, 2000, 107, p. 1436–1438.

77. Mourant, AE., Kopec, AC., Domaniewska, K. The distribution of human blood groups and other polymorphisms. London: Oxford University Press, 1976.

78. Novaretti, MC., Peres Navarro, S., Leao Bonifacio, S., et al. Comparison of gel test and tube test technique for isoagglutininstitration. Vox Sang, 2007, 93 (Suppl. 1), p. 188–189.

79. Oepkes, D., Seaward, PG., Vandenbussche, FT., et al. Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med, 2006, 13, 335, 2, p. 156–164.

80. Penka, M., Tesařová, E. Hematologie a transfuzní lékařství II. 1. vyd. Praha: Grada Publishing, 2012.

81. Pětroš, M., Ľubušký, M., Šimetka, O., Procházka, M. Aloimunizace těhotných žen non-RhD erytrocytárními antigeny: přehledový článek. Čes Gynek, 2010, 75, s. 325–333.

82. Ponťuch, A., Hrubiško, M., Michaličková, J. Hemolytická choroba novorozencov. 1. vyd. Martin: Osveta, 1970.

83. Queenan, JT., Smith, BD., Haber, JM., et al. Irregular antibodies in the obstetric patient. Obstet Gynecol, 1969, 34, 6, p. 767–771.

84. Raman, L., Amstrong, B., Smart, E. Principles of laborator techniques. Journal compilation. Oxford: Blackwell Publishing, 2008, p. 33–60.

85. Reid, ME., Lomas-Francis, C. The blood group antigen facts Book. 2nd ed. New York: Elsevier Academic Press, 2004.

86. Sakuma, K., Suzuki, H., Ohto, H., et al. First case of hemolytic disease of the newborn due to anti-Ula antibodies. Vox Sang, 1994, 66, p. 293–294.

87. Smart, E., Armstrong B. Blood group systems. Journal compilation. Oxford: Blackwell Publishing 2008, p. 68–92.

88. Southcott, J., Tanner, J., Anstee, D. The expression of human blood group antigens during erythropoesis in a cell culture systém. Blood, 1999, 93, p. 4425–4435.

89. Stanworth, S., Fleetwood, P., de Silva, M. Severe hemolytic disease of the newborn due to anti-Jsb. Vox Sang, 2001, 81, p. 134–135.

90. Stone, B., Marsh, WL. Haemolytic disease of the newborn caused by anti-M. Br J Haematol, 1959, 5, p. 344–347.

91. Studničková, M., Ľubušký, M., Ordeltová, M., Procházka, M. Možnosti stanovení fetomaternální hemoragie. Čes Gynek, 2010, 75, 5, s. 443–446.

92. Telischi, M., Behzad, O., Issitt, PD., Pavone, BG. Hemolytic disease of the newborn due to anti-N. Vox Sang, 1976, 31, 2, p. 109–116.

93. Ting, JY., Ma, ES., Wong, KY. A case of severe haemolytic disease of the newborn due to anti-Di(a) antibody. Hong Kong Med J, 2004, 10 p. 247–249.

94. Tippet, P., Lomas-Francis, C., Wallace, M. The Rh antigen D: partial D antigens and associated low incidence antigens. Vox Sang, 1996, 70, p. 123–131.

95. Trevett, TN., Moise, KJ. Twin pregnancy complicated by severe hemolytic disease of the fetus and newborn due to anti-g and anti-C. Obstet Gynecol, 2005, 106, p. 1178–1180.

96. Turgeon, ML. Fundamentals of immunohematology: Theory and technique. Philadelphia: Lea and Febiger, 1989, p. 322–343.

97. Uchikawa, M., Shibata, Y., Tohyama, H., et al. A case of hemolytic disease of the newborn due to anti-Dib antibodies. Vox Sang. 1982, 42, p. 91–92.

98. Van Dongen, H., Klumper, FJ., Sikkel, E., et al. Non-invasive tests to predict fetal anemia in Kell-alloimmunized pregnancies. Ultrasound Obstet Gynecol, 2005, 25, 4, p. 341–345.

99. Van Kamp, IL., Klumper, FJ., Bakkum, RS., et al. The severity of immune fetal hydrops is predictive of fetal outcome after intrauterine treatment. Am J Obstet Gynecol, 2001, 185, 3, p. 668–673.

100. Van Wamelen, DJ., Klumper, FJ., de Haas, M., et al. Obstetric history and antibody titr in estimating severity of Kell alloimmunization in pregnancy. Obstet Gynecol, 2007, 109, 5, p. 1093–1098.

101. Vescio, LA., Farina, D., Rogido, M., Sola, A. Hemolytic disease of the newborn caused by anti-Fyb. Transfusion, 1987, 27, 4, p. 366.

102. Wagner, T., Resch, B., Reiterer, F., et al. Pancytopenia due to suppressed hematopoesis in a case of fatal hemolytic disease of the newborn associated with anti-K supported by molecular K1 typing. J Pediatr Hematol Oncol, 2004, 26, p. 13–15.

103. Weinstein, L., Taylor, ES. Hemolytic disease of the neonate secondary to anti-Fya. Am J Obstet Gynecol, 1975, 1, 121, 5, p. 643–645.

104. Wenk, RE., Goldstein, P., Felix, JK. Alloimmunization by hr´(c) hemolytic disease of newborns and perinatal management. Obstet Gynecol 1986, 67, 5, p. 623–626.

105. Whittle, M. Rhesus haemolytic disease. Arch Dis Childhood, 1992, 67, p. 65–68.

106. Žižka, Z., Hájek, Z., a kol. Rizikové a patologické těhotenství. Praha: Grada Publishing, 2004, s. 83–94.