1例冷反应性IgG抗-Mur引起新生儿溶血病的血清学研究

Serological study of hemolytic disease of newborn caused by cold reactive IgG anti-Mur in 1 case

目的对1例由IgG抗-Mur引起的新生儿溶血病(HDN)进行血清学分析,并了解其抗体的特性。方法采用常规血型血清学方法进行ABO血型鉴定、Rh分型、MN、Mur表型、直接抗人球蛋白试验(DAT)、不规则抗体筛查、抗体特异性鉴定及抗体效价(不同放散法、不同温度)检测。结果患儿血型为AB型、CCDee、MN、Mur抗原阳性,患儿父母血型分别为A型、Cc DEe、MM、Mur抗原阳性和AB型、CCDee、MN、Mur抗原阴性。患儿DAT弱阳性。患儿血清检出IgG抗-E、抗-Mur抗体,红细胞放散液中检出IgG抗-Mur抗体;其母亲血清中检出(IgM+IgG)抗-E、抗-Mur抗体。患儿血清IgG抗-Mur效价:患儿血清、放散液、母亲血清在4℃下的效价明显高于37℃,且热放散效价高于酸放散效价。结论抗-Mur可导致严重的新生儿溶血病,该IgG抗体具有冷反应特性。

Objective A case of neonatal hemolytic disease(HDN)caused by IgG anti-Mur was serologically analyzed and the characteristics of its antibodies were studied.Methods ABO blood typing,Rh typing,MN,Mur phenotype,direct antihuman globulin test(DAT),irregular antibody screening,antibody specificity and antibody titer(different dispersion methods,different temperatures)were detected by routine blood group serology.Results The neonatal blood group was AB type,CCDee,MN,Mur antigen with positive,and his parents blood group were A type,CcDEe,MM,Mur antigen with positive and AB type,CCDee,MN,Mur antigen with negative,respectively.Direct anti-human globulin test was weak positive.IgG anti-E and anti-Mur antibody were identified in neonatal serum,while only IgG anti-Mur antibody was detected in neonatal erythrocytes,and(IgM/IgG)anti-E and anti-Mur antibody were detected in his maternal serum.The titer of children serum IgG anti-MUR:the titer of children serum,release solution and mother serum at 4℃was significantly higher than that at37℃,and the heat release titer was higher than the acid release titer.Conclusion IgG anti-Mur antibody can lead to severe hemolytic disease of newborn,but it has cold reaction characteristics.