Fetal and neonatal anemia associated with anti-Jr(a) : a case report showing a poorly hemolytic mechanism
Fetal and neonatal anemia associated with anti-Jr(a) : a case report showing a poorly hemolytic mechanism
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与抗 Jr(a) 相关的胎儿和新生儿贫血：显示溶血机制不良的病例报告
DOI：
10.1111/j.1447-0756.2010.01477.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
et al
中科院分区：
文献类型：
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作者：
Sasamoto N;Tomimatsu T;et al
虽然最近发表的病例报告表明Jraallo免疫在产科环境中的重要性，但所涉及的机制仍不清楚。在这里，我们报告了一例与抗Jraallo免疫相关的严重胎儿和新生儿贫血，使用多普勒评估胎儿大脑中动脉（MCA-PSV）的收缩期峰值流速成功治疗。一例日本女性抗Jra抗体（滴度1024）在妊娠20周时转诊至我科。 由于胎儿MCA-PSV超过中位数的1.5倍，因此引产，并在妊娠33周零5天时经阴道分娩了一名1998 g的女性新生儿。 婴儿的红细胞压积和血红蛋白水平分别为25.4%和82 g/L，但总胆红素水平（15 µmol/L; 0.9 mg/dL）和网织红细胞计数（4.5%）较低。 在此过程中，婴儿没有表现出明显的溶血迹象。非溶血性免疫应被认为是胎儿贫血的可能原因，但没有直接的溶血过程。
Although recently published case reports suggest the significance of Jraalloimmunization in the obstetric setting, the involved mechanism still remains unclear. Here we report a case of severe fetal and neonatal anemia associated with anti‐Jraalloimmunization, which was successfully managed using Doppler assessment of peak systolic velocity of the fetal middle cerebral artery (MCA‐PSV). A Japanese woman with anti‐Jra(titer 1024) was referred to our department at 20 weeks' gestation. As fetal MCA‐PSV exceeded 1.5 multiple of median, labor was induced and a female neonate of 1998 g was delivered vaginally at 33 weeks and 5 days of gestation. The infant's hematocrit and hemoglobin levels were 25.4% and 82 g/L, respectively, but her total bilirubin level (15 µmol/L; 0.9 mg/dL) and reticulocyte counts (4.5%) were low. During the course, the infant showed no apparent signs of hemolysis. Jraalloimmunization should be recognized as a possible cause of fetal anemia with no direct hemolytic process.