Anti-Co(a) implicated in severe haemolytic disease of the foetus and newborn

Transfusion Medicine
Bogumiła MichalewskaR Bartkowiak

Abstract

The Colton (Co(a)) antigen is of high frequency; its incidence in Caucasians is about 99.8%. Reports on haemolytic transfusion reactions and haemolytic disease of the foetus/newborn (HDFN) due to anti-Co(a) are rare. We report a severe HDFN due to anti-Co(a). The first child of the mother was healthy. The second died a few hours after delivery because of hydrops fetalis, likely due to HDFN; anti-Co(a) in the maternal serum, the father typed as Co(a+). The third pregnancy was followed up by the measurements of anti-Co(a) titre (additional antibodies were excluded), its functional activity by the chemiluminescence test (CLT) and the Doppler flow in the middle cerebral artery of the foetus. Increased values of antibody titre up to 128, the CLT to 30% and multiplex of median of the peak systolic velocity to 1.71 indicated haemolytic disease and the necessity for an intrauterine transfusion. The foetus received the maternal red blood cells (RBCs). Delivery had to be by Caesarean section for obstetrical reasons at 34-week gestation. The newborn (anti-Co(a) on red cells and in plasma, the rise of the bilirubin concentration up to 333 micromol L(-1)) had four exchange transfusions: the first of maternal RBCs, the remaining of donor's C...Continue Reading

References

Jan 1, 1976·Transfusion·C McIntyreA L Larsen
Jan 1, 1970·Vox Sanguinis·D S SmithR Riches
Mar 14, 2002·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·G Daniels
May 30, 2021·Immunohematology·Randal B CovinHannis W Thompson

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Citations

Mar 22, 2016·Transfusion Medicine·N KimmichR Zimmermann
Jun 7, 2019·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Michael VegaRyan Chadha

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