母婴 ABO血型不合合并 IgG抗-M抗体引起新生儿溶血病 1例

目的 分析ABO血型不合合并低效价免疫球蛋白G(IgG)抗-M抗体引起的新生儿溶血病的临床特点.方法 报告ABO血型不合合并低效价IgG抗-M抗体引起的新生儿溶血病(HDN)1例,病例样本为2017年11月河北省血液中心接收的临床病人标本,对病儿及其父母进行血型鉴定,利用抗体鉴定谱细胞检测病儿及其母亲血清、病儿红细胞放散液中存在的抗体,并进行抗体效价测定.结果 母亲与病儿血清及放散液中均含有抗-M抗体且病儿合并ABO-新生儿溶血病,即ABO-HDN,母亲血清在盐水介质测得免疫球蛋白M(IgM)抗-M效价为64;母亲血清经2-巯基乙醇(2-Me)处理后,抗人球蛋白试验测得IgG抗-M效价为4.结论 IgG抗-M抗体引起的新生儿溶血病极其少见,但极易造成严重的新生儿溶血病,在临床产前筛查时应给予重视.

Analysis of a case of neonatal hemolytic disease caused by mother-infant ABO blood group incompatibility combined with low titer IgG anti-M antibody

Objective To analyze the clinical feature of neonatal hemolytic disease caused by ABO blood group incompatibilitycombined with low titer Immunoglobulin G (IgG) anti-M antibody.Methods A case of hemolytic direare of newborn (HDN) caused by ABO blood group incompatibility combined with inefficient IgG anti-M antibody was reported. The case samples were clinical patientsamples received by Hebei Blood Center in November 2017. The antibodies in the blood type of the infant and her parents and in theerythrocytes of sick children were identified by using antibody identification profile cells. The antibody titer was determined.Results The mother and child''s serum and the release solution contained anti-M antibody, and the sick child was combined with ABO-hemolytic disease of the newborn, namely ABO-HDN. The anti-M titer of the Immunoglobulin M (lgM) in the mother serum was 64 by using saline medium. After the mother serum was treated with 2-Me, the anti-M titer of IgG was 4 by using the anti-human globulin test.Conclu? sion Neonatal hemolytic disease caused by IgG anti-M antibody is rare, but it is easy to cause severe neonatal hemolytic disease. Thedoctors must be sensitive during clinical prenatal screening.