Abstract
Background
Piperacillin antibody-induced immune hemolytic anemia is not rare in adults, and there
have been reports of anti-HLA antibody-induced newborn platelet transfusion refractoriness.
However, there has been no report of piperacillin-accompanied anti-HLA antibody-induced
newborn pancytopenia.
Case Report
We herein present the case of a newborn with pancytopenia from a mother who carried
anti-HLA-B55, anti-HLA-DR11, and piperacillin antibodies. The newborn HLA genotypes
were HLA*B55:02 and HLA*DRB1*11:01. IgG antibodies can be transferred to the newborn
via the placenta and induce the destruction of the platelet and white blood cells,
which carry the corresponding antigens. Piperacillin antibodies coupling with newborn
red blood cells (RBCs) led to the destruction of the RBCs and hemolytic anemia.
Results
The direct anti-globulin test was positive for RBCs in the newborn, and piperacillin
antibodies were positive in both the newborn and his mother. Anti-HLA antibodies were
positive in the maternal serum, whereas homologous antigens were positive in the newborn.
The direct anti-globulin test of platelet was weekly positive in the newborn.
Conclusion
Piperacillin and anti-HLA antibodies can pass through the placenta, induce incompatible
blood cell destruction, and cause a series of clinical syndromes in newborns.
Keywords
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References
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Article info
Publication history
Published online: November 23, 2021
Accepted:
November 20,
2021
Received in revised form:
November 16,
2021
Received:
April 9,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
