title: Late onset neonatal anaemia due to maternal anti-Kp(b) induced haemolytic disease of the newborn.
abstract: BACKGROUND
  Alloanti-Kp(b) is a rare, clinically significant antibody against high frequency red cell antigen Kp(b) of Kell blood group system. We report here a case of Haemolytic disease of newborn (HDN) due to anti-Kp(b), which manifested as severe anaemia at the age of 1 month.
  
  
  OBJECTIVE
  To diagnose and successfully manage anti-Kp(b) induced HDN.
  
  
  METHODS
  Direct antiglobulin test (DAT), antigen typing, irregular antibody screening and identification were done by polyspecific LISS Coombs Gel card and standard methods.
  
  
  RESULTS
  At presentation the neonate had severe anemia with reticulocytopenia. Blood group was B, Rh D positive and DAT was 2+. Anti-Kp(b) was detected in mother's serum. Due to unavailability of Kp(b) negative red cells and incompatible blood group of mother (A(1)B Rh D positive) infant was transfused group B Rh D, Kp(b) positive PRBCs under steroid cover. He was symptom free at 4 months of age and DAT became negative at 6 months.
  
  
  CONCLUSIONS
  Anti-Kp(b) is capable of causing severe late HDN. Infants born to irregular antibody positive mothers should be investigated and closely monitored for several weeks after birth for immune HDN even if asymptomatic at birth.
authors.affiliation: Dept. of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. pelhence@sgpgi.ac.in
authors.forename: Priti
authors.initials: P
authors.lastname: Elhence
authors.forename: Deepti
authors.initials: D
authors.lastname: Sachan
authors.forename: Anupam
authors.initials: A
authors.lastname: Verma
authors.forename: Archana
authors.initials: A
authors.lastname: Kumar
authors.forename: Rajendra
authors.initials: R
authors.lastname: Chaudhary
mesh_terms: D000751:Anemia, Neonatal / Q000097:blood / Q000276:immunology; D005260:Female; D006402:Hematologic Diseases / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood; D007626:Kell Blood-Group System / Q000276:immunology*; D008297:Male; D011247:Pregnancy
chemical_list: D007518:Isoantibodies; D007626:Kell Blood-Group System