Abstract
Maternal IgG antibodies directed against fetal red cells can cause hemolytic disease
in fetus and newborn manifesting as anemia and jaundice. Sometimes, these antibodies
are so strong that they encapsulate the antigens on neonatal red blood cells and result
in erroneous laboratory findings when tested. A requisition for double volume exchange
transfusion was received for a term,3.1 kg female baby with neonatal jaundice at day
2 of life, born to a multiparous woman. The neonate was typed as AB RhD negative and
the mother as A Rh D negative. The maternal sample tested positive for Indirect antiglobulin
testing showing presence of Anti-D with IgG titer of 128. The direct antiglobulin
testing for baby was strongly (4 +) positive. The strong DAT result with negative
RhD typing for the neonate indicated towards the Blocking-D phenomenon. We attempted
to resolve the Blocked-D case using acid elution, which revealed the presence of D
antigen on the eluted neonate's red cells. The report emphasizes the importance of
appropriate blood typing for neonates to provide prompt adequate care as a team by
the departments of Neonatology and Transfusion Medicine.
Keywords
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Article info
Publication history
Published online: April 06, 2022
Accepted:
April 1,
2022
Received in revised form:
March 15,
2022
Received:
December 24,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
