A fatal case of necrotizing enterocolitis in a neonate with polyagglutination of red blood cells.
An infant of 30 weeks gestation developed necrotizing enterocolitis (NEC) 8 days after birth and died 2 days later after a fulminating course. During her illness she received two blood transfusions, both of which produced sub-optimal rises in her haemoglobin and were associated with evidence of haemolysis. Retrospective analysis demonstrated T antigen (Tk) polyagglutination of the infant's red blood cells and donor plasma. Although bacterial cultures were negative throughout the course of the illness in this case, T antigen exposure is associated with certain anaerobic infections and with severity of NEC. Infants with NEC should be regularly screened for T antigen exposure and if this test is positive, plasma (immunoglobulin) containing infusions should be avoided.
Marshall
L R
LR
Department of Pathology, King Edward Memorial Hospital for Women, Subiaco, Western Australia.
Barr
A L
AL
French
N P
NP
Lown
J A
JA
Knowles
S
S
D016913:Blood Component Transfusion; D004761:Enterocolitis, Pseudomembranous / Q000097:blood / Q000276:immunology* / Q000382:microbiology / Q000628:therapy; D004903:Erythrocyte Aggregation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011549:Pseudomonas / Q000276:immunology* / Q000302:isolation & purification; D012189:Retrospective Studies