罕见M+Le(a+)HDFN病例1例并文献复习

Rare hemolytic disease in fetuses and newborns with M+Le(a+):a case report and review of literatures

目的通过1例母儿罕见血型不合病例对胎儿和新生儿溶血病(HDFN)进行国内外文献复习及总结。方法总结该罕见病例的病史,分析并对比该家系的各个血型系统,回顾性分析国内外相关研究进展。结果该病例以“胎儿不明原因胸腔积液”为主要表现,既往有“晚孕期胎动减少、新生儿不明原因死亡”病史。经家系血型分析认为M+Le(a+)是导致该病例母儿血型不合的主要原因。结合文献分析MN血型或许与Lewis血型具有协同作用。结论在孕期管理中应重视对不典型胎儿水肿、胎动减少等孕妇进行不规则抗体和大脑中动脉收缩期峰值流速筛查,重视不同血型系统协同致病的潜在风险,并加强对HDFN的认识和规范管理。

Objective To review and summarize the literatures on hemolytic disease in the fetuses and newborns(HDFN)through a case of rare maternal-fetal blood group incompatibility.Methods The history of this rare case was summarized,the various blood groups system of this family were analyzed and compared.The relevant study progress at home and abroad was retrospectively analyzed.Results This case was mainly manifested by"unexplained fetal pleural effusion",with the previous history of"fetal movement decrease in late pregnancy and unexplained newborn death".M+Le(a+)blood type was the main reason causing this case of maternal-fetal blood group incompatibility.By combining with the literatures analysis,the MN blood group might perhaps have the synergistic effect with the Lewis blood group.Conclusion In pregnancy management,should pay attention to the pregnant women with atypical fetal edema,fetal movement decrease,etc.to conduct the irregular antibodies and middle cerebral artery peak systolic velocity screening,and focus on the potential risk of synergistic pathogenesis of different blood groups systems,and strengthen the recognition and standardized management on HDFN.