title: Role for serial prenatal anti-Vel quantitative serologic monitoring with 2-ME serum treatment during pregnancy: case report.
abstract: Anti-Vel is an uncommon antibody to a high-prevalence antigen. Its clinical significance and management in the prenatal setting are not well characterized. We present a case that demonstrates the utility of serial prenatal anti-Vel quantitative serologic monitoring with 2-ME serum treatment during pregnancy. The patient is a 23-year-old Hispanic woman with history of prior pregnancy and prior transfusion who was discovered to have an antibody to the high-prevalence Vel antigen in the first trimester (week 7) of her second pregnancy. Interval measurements of the serologic antibody titers were performed during the next 26 weeks. The untreated serum (IgM and IgG) titer increased from a baseline of 4 to 16 during that interval, while the 2-ME (presumed IgG component) titer remained stable at 4. Responding to ultrasound findings suspicious for fetal anemia, the child was delivered without complications at 34 weeks' gestation. At birth, the DAT was negative and there was no evidence of HDN. Placed in the context of other similar reports, this case demonstrates the importance of separately reporting the IgG fraction (after either DTT treatment or 2-ME treatment) from the untreated (IgM and IgG) fraction and the importance of correlating the treated serum titer with potential clinical significance.
authors.affiliation: Scott and White Transfusion Service and Donor Center, Texas A&M UHSC, Temple TX 76508, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Linz
authors.forename: J T
authors.initials: JT
authors.lastname: Fueger
authors.forename: S
authors.initials: S
authors.lastname: Allen
authors.forename: S T
authors.initials: ST
authors.lastname: Johnson
mesh_terms: D000740:Anemia / Q000097:blood / Q000000981:diagnostic imaging / Q000235:genetics; D000918:Antibody Specificity; D001789:Blood Group Antigens / Q000276:immunology*; D002585:Cesarean Section; D004229:Dithiothreitol / Q000494:pharmacology; D017558:Elective Surgical Procedures; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000517:prevention & control*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005315:Fetal Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000235:genetics; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008623:Mercaptoethanol / Q000494:pharmacology; D011247:Pregnancy; D011295:Prenatal Care; D044967:Serum / Q000187:drug effects / Q000276:immunology; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D001789:Blood Group Antigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007518:Isoantibodies; D008623:Mercaptoethanol; D004229:Dithiothreitol