抗-G合并抗-D抗体所致新生儿溶血病1例

A case of neonatal hemolytic disease caused by anti-G combined with anti-D antibody

目的研究抗-G合并抗-D所致新生儿溶血病的血清学特征,为临床诊断和治疗提供依据。方法采用常规血型血清学方法检测患儿及其父母的ABO血型、Rh血型,对患儿母亲进行不规则抗体筛查、抗体鉴定、吸收放散以及抗体效价测定,对患儿红细胞进行直接抗球蛋白试验(DAT)和放散试验,患儿血清做抗体鉴定。结果父亲为B型,Rh血型CCDee;母亲为A型,Rh血型ccdEe,血清中检出有IgM抗-D和IgG型抗-D、抗-G抗体,IgM抗-D效价为1:2,IgG型抗-G效价为1:8,抗-D+G效价为1:128;患儿DAT为1+,ABO血型为AB型,Rh血型为CcDEe,血清和放散液中均检出IgG抗-D、抗-G抗体,未检出IgG抗-B抗体。结论抗-G抗体可引起新生儿溶血病,需要通过多次吸收放散试验来分析确定。

Objective To study the serological characteristics of hemolytic disease of the newborn caused by anti-G combined with anti-D,and to provide basis for clinical diagnosis and treatment.Methods ABO/Rh blood type of neonatus and their parents were detected by conventional blood type serological methods.Irregular antibody screening,antibody identification,absorption and elution tests,antibody titer determination were carried out to the maternal samples.Neonatal erythrocytes were conducted by direct antiglobulin test(DAT)and absorption and elution tests,and her serum was conducted for antibody identification.Results Her father is type B,Rh type CCDee.Her mother was type A,Rh type ccdEe.And IgM anti-D and IgG anti-D,anti-G antibodies were detected in the serum.The titers of IgM anti-D,IgG anti-G and anti-D+G were 1:2,1:8 and 1:128,respectively.ABO/Rh blood groups was AB,CcDEe.IgG anti-D and anti-G antibodies were detected in her serum and eluates,but IgG anti-B antibody was not detected.Conclusion Anti-G antibody can cause hemolytic disease,which needs to be determined by repeated absorption and elution tests.