Blocked D phenomenon, a rare condition with Rh D haemolytic disease of newborn – a case report
Blocked D phenomenon, a rare condition with Rh D haemolytic disease of newborn – a case report
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DOI：
10.1111/j.1751-553x.2007.00943.x
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发表时间：
2008-06
影响因子：
3
通讯作者：
P. Sulochana;A. Rajesh;J. Mathai;S. Sathyabhama
中科院分区：
文献类型：
--
作者：
P. Sulochana;A. Rajesh;J. Mathai;S. Sathyabhama
如果红细胞被IgG抗D抗体严重包被，准确的Rh检测可能很困难-这种现象称为D阻断。一位B Rh D阴性母亲的第二胎所生的新生男婴患有严重溶血性疾病和核黄疸，再次获得Rh D阴性血型报告。经调查，该婴儿按直接分型法被分型为B Rh D阴性，但洗脱后检测到D抗原，表型为CcDe。抗体经鉴定为抗D。婴儿的所有D抗原都被抗D完全饱和，留下任何抗原与抗血清结合。直接Coombs试验强阳性，即使经过三次交换输血。除了结合的红细胞和红细胞外，婴儿还具有游离抗体，滴度为512。母亲被分组为B Rh D阴性，表型为ce。她有IgM和IgG类抗D，滴度分别为32和1024。她还检测了IgM抗C（仅纯品）和IgG抗A，滴度为512。
Accurate Rh testing can be difficult if the red cells are heavily coated with IgG anti D antibodies – a phenomenon called blocked D. Repeatedly, Rh D negative blood group report was obtained in a newborn male baby with severe haemolytic disease and features of kernicterus born to a 2nd gravida B Rh D negative mother. On investigation, the baby was grouped as B Rh D negative by direct grouping, but after elution, D antigen was detected and phenotyped as CcDe. Antibody was identified as anti D. All D antigens of the baby were fully saturated with anti D leaving any antigen to bind with antisera. Direct Coombs test was strongly positive even after three exchange transfusions. The baby also had free antibody apart from the red cell bound and the red cell eluate, gave a titre of 512. The mother was grouped as B Rh D negative and phenotyped as ce. She had IgM and IgG class of anti D with titres 32 and 1024 respectively. She also had IgM anti C (only in neat) and IgG anti‐A with a titre of 512.