Isolated anaemia as a manifestation of Rh isoimmunisation.
Rh isoimmunisation leads to haemolytic anaemia and hyperbilirubinaemia in the first h of life. Isolated early onset neonatal anaemia has rarely been reported. The authors describe the case of a term infant, born to an 'A' negative, second gravida mother. On the second day of life, pallor was noticed. His haemoglobin (Hb) was 6.8 g/dl, he had reticulocytosis and a positive direct antiglobulin test. However, he did not have a high total serum bilirubin (TSB) (87.2 μmol/l). He was transfused with red blood cells and kept under phototherapy for 3 days. Three weeks later, he received another transfusion for severe anaemia (Hb 6 5 g/dl). During this period, he was never jaundiced and the maximum level of TSB was 122 μmol/l. On follow-up, his Hb stabilised and he had no further problems. This report highlights the possibility of early onset anaemia without jaundice as the sole manifestation of Rh isoimmunisation.
Neonatal Intensive Care Unit, Maternidade Bissaya Barreto-CHC, Coimbra, Portugal. juroda@hotmail.com
Juliana
J
Roda
Gabriela
G
Mimoso
Manuela
M
Benedito
Dolores Faria
DF
Pereira
D000748:Anemia, Macrocytic / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D001663:Bilirubin / Q000097:blood; D017707:Erythrocyte Transfusion; D005492:Folic Acid / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D008297:Male; D010789:Phototherapy; D012203:Rh Isoimmunization / Q000150:complications* / Q000276:immunology / Q000628:therapy
D006454:Hemoglobins; D005492:Folic Acid; D001663:Bilirubin