title: Use of recombinant erythropoietin for the management of severe hemolytic disease of the newborn of a K0 phenotype mother.
abstract: Very few people do not express any Kell antigens on their red blood cells (K0 phenotype). They can be immunized by transfusion or pregnancy and develop antibodies against Kell system antigens. These maternal antibodies can cause severe hemolytic disease of the fetus/newborn, as a result of the suppression of erythropoiesis and hemolysis. Multiple intrauterine transfusions in the management of severe hemolytic disease have been shown to cause erythropoietic suppression as well. Recombinant erythropoietin has been successfully used in the management of late anemia of infants with Rh hemolytic disease and in 1 case of KEL1 (Kell)-associated hemolytic disease. The authors present the case of severe hemolytic disease of a newborn due to KEL5 (Ku) isoimmunization of his K0 phenotype mother. Regular intrauterine transfusions were performed to manage the severe fetal anemia (Hb 3 g/dL). A male infant was born at the 36th week of gestation having normal hemoglobin (15.8 g/dL) and developed only mild hyperbilirubinemia. On the 15th day of life, the infant's hematocrit had fallen to 27.3%, with low reticulocyte count and low erythropoietin level. The infant was managed successfully with recombinant erythropoietin.
authors.affiliation: Department of Neonatology, University of Crete, Crete, Greece.
authors.forename: Antonia
authors.initials: A
authors.lastname: Manoura
authors.forename: Eftychia
authors.initials: E
authors.lastname: Korakaki
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Hatzidaki
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Saitakis
authors.forename: Sofia
authors.initials: S
authors.lastname: Maraka
authors.forename: Isabella
authors.initials: I
authors.lastname: Papamastoraki
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Matalliotakis
authors.forename: Kaliopi
authors.initials: K
authors.lastname: Foundouli
authors.forename: Christine
authors.initials: C
authors.lastname: Giannakopoulou
mesh_terms: D000328:Adult; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000188:drug therapy*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007626:Kell Blood-Group System; D008297:Male; D011247:Pregnancy; D011994:Recombinant Proteins
chemical_list: D006397:Hematinics; D007626:Kell Blood-Group System; D011994:Recombinant Proteins; D004921:Erythropoietin