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Hydrops Fetalis due to Kell Alloimmunization: A Perinatal Approach to a Rare Case

机译:由于凯尔同种异体免疫而导致的胎儿水肿:一种罕见病例的围产期方法

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摘要

>Objective: While routine administration of rhesus (Rh) immunoglobulin has significantly reduced the incidence of Rh alloimmunization, maternal alloimmunization to other red cell antigens remains a contributor to perinatal morbidity and mortality. Although the Kell antigen is seen on the red cells of only 9% of the general population, attention to Kell antibodies continues to increase.>Case Report: A case of fetal hydrops was sonographically detected at 30 weeks of gestation. Antenatal tests to evaluate the fetus’s condition clearly showed that the level of hemolytic disease was critical and the baby was delivered prematurely due to fetal distress. The combination of anemia, reticulocytopenia, hydrops fetalis, and a positive indirect Coombs test suggested Kell isoimmunization. The baby was successfully treated with exchange transfusion of Kellnegative packed red cells, and was discharged on postnatal d 30.>Conclusion: The presented case of hydrops fetalis was due Kell alloimmunization that was detected during the postnatal period, and thus we plan to discuss the perinatal approach to Kell immunization.
机译:>目的:尽管常规给予恒河猴(Rh)免疫球蛋白已大大降低了Rh同种免疫的发生率,但母亲对其他红细胞抗原的同种免疫仍然是围产期发病率和死亡率的一个原因。尽管仅在总人口的9%的红细胞中发现了Kell抗原,但对Kell抗体的关注仍在增加。>病例报告:在妊娠30周时通过超声检查发现了一例胎儿积液。评估胎儿状况的产前测试清楚地表明,溶血性疾病的水平至关重要,婴儿因胎儿窘迫而早产。贫血,网状细胞减少,胎儿积水和间接Coombs阳性试验的结合提示了Kell同种免疫。婴儿通过交换输注凯氏阴性的红细胞成功治疗,并在出生后30天出院。>结论:本例胎儿水肿是由于在出生后检测到凯氏同种异体免疫引起的,因此,我们计划讨论凯尔免疫的围产期方法。

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