title: Hemolytic disease of the newborn caused by anti-Wright (anti-Wra): case report and review of literature.
abstract: Antibodies to red cell antigens that are found at low frequency in the general population are rare causes of hemolytic disease of the newborn. To understand how to detect these cases, we provide a basic review of routine antenatal maternal antibody testing and report a case of a neonate with severe HDN caused by anti-Wright (anti-Wra), successfully managed with transfusion, phototherapy, and high-dose intravenous immunoglobulin. When hemolysis in a newborn is suspected in the absence of major blood group incompatibility or commonly detected maternal red cell antibodies, a direct antiglobulin test should be performed. A positive DAT should alert the clinician to the presence of maternal antibodies against low-incidence antigens. Antibodies to the Wra antigen are one such rare cause of HDN.
authors.affiliation: NICU at Sunnybrook Health Sciences Center, Toronto, Canada. A.J.Squires@mail.com
authors.forename: Amanda
authors.initials: A
authors.lastname: Squires
authors.forename: Nehad
authors.initials: N
authors.lastname: Nasef
authors.forename: Yulia
authors.initials: Y
authors.lastname: Lin
authors.forename: Jeannie
authors.initials: J
authors.lastname: Callum
authors.forename: Emad M
authors.initials: EM
authors.lastname: Khadawardi
authors.forename: Christine
authors.initials: C
authors.lastname: Drolet
authors.forename: David
authors.initials: D
authors.lastname: Core
authors.forename: Brian
authors.initials: B
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis*; D001324:Autoantigens / Q000276:immunology*; D001789:Blood Group Antigens / Q000276:immunology*; D001787:Blood Group Incompatibility; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007231:Infant, Newborn
chemical_list: D000906:Antibodies; D001324:Autoantigens; D001789:Blood Group Antigens; D007074:Immunoglobulin G