Hemolytic disease of the fetus and newborn due to anti-Ge3: combined antibody-dependent hemolysis and erythroid precursor cell growth inhibition.
The Gerbich (Ge) antigens are a collection of high-incidence antigens carried on the red blood cell membrane glycoproteins, glycophorins C and D. Antibodies against these antigens are uncommon, and there have been only rare case reports of hemolytic disease of the fetus and newborn due to anti-Ge. In this case report, we present a neonate with severe anemia and hyperbilirubinemia due to anti-Ge3. Routine and special laboratory studies undertaken in this case suggested two mechanisms for the patient's hemolysis and persistent anemia. Antibody-dependent hemolysis was associated with early-onset hyperbilirubinemia, anemia, and a mild reticulocytosis, and inhibition of erythroid progenitor cell growth was associated with late anemia and normal bilirubin and reticulocyte values. Though rare, anti-Ge3 can be a dangerous antibody in pregnancy. Affected neonates may require intensive initial therapy and close follow-up for at least several weeks after delivery.
Blackall
Douglas P
DP
University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA. blackalldouglasp@uams.edu
Pesek
Gina D
GD
Montgomery
Matthew M
MM
Oza
Krishna K
KK
Arndt
Patricia A
PA
Garratty
George
G
Shahcheraghi
Ali
A
Denomme
Gregory A
GA
D000328:Adult; D001789:Blood Group Antigens / Q000276:immunology*; D001803:Blood Transfusion / Q000379:methods; D004899:Erythroblastosis, Fetal / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D015672:Erythroid Precursor Cells / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000276:immunology*; D008297:Male; D008431:Maternal-Fetal Exchange / Q000276:immunology; D011247:Pregnancy; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001789:Blood Group Antigens; D007518:Isoantibodies