title: Hemolytic disease of the fetus and newborn caused by anti-Lan.
abstract: BACKGROUND
  Antibodies to the high-incidence red blood cell (RBC) antigen Lan (Langereis) are typically immunoglobulin G and have been shown to fix complement and cause hemolysis of Lan antigen-positive RBCs. Only three cases of hemolytic disease of the fetus and newborn (HDFN) have been reported involving anti-Lan and all have been characterized as "mild."
  
  
  METHODS
  A 26-year-old Hispanic female presented in her fifth pregnancy for routine obstetric care. Due to progressively rising anti-Lan titers, middle cerebral artery (MCA) Dopplers were performed. At 32 weeks of gestation, the antibody titer had reached 128; the MCA Doppler indicated that fetal anemia was severe. An intrauterine transfusion with Lan antigen-negative RBCs was performed and a viable infant was delivered 25 days later.
  
  
  CONCLUSIONS
  Three cases of HDFN associated with anti-Lan have been previously reported. While these cases have been associated with somewhat variable serologic findings, none have resulted in fetal demise or severe symptomatology requiring pre- or postnatal intervention other than routine phototherapy. The current report, however, suggests that in some instances anti-Lan can result in a more severe form of HDFN requiring more aggressive prenatal therapy.
  
  
  CONCLUSIONS
  In spite of previous case reports suggesting that anti-Lan is associated with relatively mild HDFN, this case suggests that in some instances, this antibody can cause severe HDFN requiring prenatal intervention.
authors.affiliation: Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Sarah
authors.initials: S
authors.lastname: Brooks
authors.forename: Jerry E
authors.initials: JE
authors.lastname: Squires
mesh_terms: D000328:Adult; D004899:Erythroblastosis, Fetal / Q000209:etiology*; D005260:Female; D006801:Humans; D007519:Isoantigens / Q000276:immunology*; D011247:Pregnancy
chemical_list: D007519:Isoantigens; C083301:LAN antigen