title: Blueberry muffin rash, hyperbilirubinemia, and hypoglycemia: a case of hemolytic disease of the fetus and newborn due to anti-Kp(a).
abstract: Hemolytic disease of the fetus and newborn occurs when maternal IgG antibodies cross the placenta and cause hemolysis of fetal red blood cells. Kp(a) is a low frequency red blood cell antigen that has rarely been implicated in hemolytic disease of the fetus and newborn. The few reported cases attributed to anti-Kp(a) have typically had minimal clinical consequences. We report a critically ill neonate who presented with purpura, respiratory failure, severe liver dysfunction, hyperbilirubinemia, hypoglycemia and anemia. This case report broadens the spectrum of neonatal disease associated with anti-Kp(a), addresses the evaluation of hemolysis with liver failure in a neonate, and emphasizes the importance of screening for antibodies to low frequency red blood cell antigens in suspected hemolytic disease of the fetus and newborn.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA. brum0036@umn.edu
authors.forename: J E
authors.initials: JE
authors.lastname: Brumbaugh
authors.forename: S
authors.initials: S
authors.lastname: Morgan
authors.forename: J C
authors.initials: JC
authors.lastname: Beck
authors.forename: N
authors.initials: N
authors.lastname: Zantek
authors.forename: S
authors.initials: S
authors.lastname: Kearney
authors.forename: C M
authors.initials: CM
authors.lastname: Bendel
authors.forename: K D
authors.initials: KD
authors.lastname: Roberts
mesh_terms: D000743:Anemia, Hemolytic / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D000751:Anemia, Neonatal / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001787:Blood Group Incompatibility / Q000097:blood / Q000150:complications / Q000503:physiopathology; D002756:Cholagogues and Choleretics / Q000008:administration & dosage; D004899:Erythroblastosis, Fetal / Q000209:etiology*; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood; D007003:Hypoglycemia / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007155:Immunologic Factors / Q000008:administration & dosage; D007231:Infant, Newborn; D007626:Kell Blood-Group System / Q000097:blood*; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000503:physiopathology; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage
chemical_list: D002756:Cholagogues and Choleretics; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007626:Kell Blood-Group System; D014580:Ursodeoxycholic Acid