Non-anti-D antibodies in red-cell alloimmunization.
OBJECTIVE
Review the fetal/neonatal outcome and management of pregnancies associated with alloimmunization to irregular anti-red-cell antibodies.


METHODS
Computerized MEDLINE search using keywords that included hemolytic disease of the newborn (HDN) and the specific family of anti-red-cell antibody, such as anti-Kell antibody.


RESULTS
A review of the prevalence of antibodies associated with HDN in reproductive age women revealed a marked decrease in the incidence of anti-RhD. An increasing incidence of anti-K1 antibody has been noted in the US, a trend not seen in other countries. Guidelines for intervention in cases of irregular antibodies are limited by the bias of anecdotal reports in the literature in favor of severe cases of HDN.


CONCLUSIONS
In cases of Kell, M, Duffy and Kidd alloimmunization, DNA techniques using amniotic fluid can be used to exclude antigen-negative fetuses. Kell (K1 and K2) alloimmunization should be managed somewhat differently from RhD due to the unique ability of these antibodies to suppress the fetal erythropoietic response.
Moise
K J
KJ
Division of Maternal-Fetal Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7570, USA. kmoisejr@med.unc.edu
D004375:Duffy Blood-Group System / Q000276:immunology; D004899:Erythroblastosis, Fetal / Q000276:immunology* / Q000628:therapy; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies; D007626:Kell Blood-Group System / Q000276:immunology*; D007667:Kidd Blood-Group System / Q000276:immunology; D008951:MNSs Blood-Group System / Q000276:immunology*; D011247:Pregnancy; D011256:Pregnancy Outcome
D004375:Duffy Blood-Group System; D007518:Isoantibodies; D007626:Kell Blood-Group System; D007667:Kidd Blood-Group System; D008951:MNSs Blood-Group System