Korean J Blood Transfus.  2019 Dec;30(3):241-245. 10.17945/kjbt.2019.30.3.241.

A Case of Hemolytic Disease of Newborn due to Anti-Di(a): Consideration of the Inclusion of Di(a) Antigen in Antibody Screening Test

Affiliations
  • 1Department of Pediatrics, Dong-A University Hospital, Busan, Korea.
  • 2Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. progreen@dau.ac.kr
  • 4Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea. myojing@dau.ac.kr

Abstract

The Diego blood group is expressed as the Di(a) antigen and Di(b) antigen, and the frequency of the Di(a) antigen among the Korean population is estimated to be 9.4~14.5%. We report here on a case of hemolytic disease caused by anti-Di(a) antibody. A full-term male infant was admitted due to hyperbilirubinemia on the first day of life. The total bilirubin level was decreased after phototherapy, but the hemoglobin level was decreased 6.9 g/dL and an exchange transfusion was then performed. The direct antiglobulin test was strongly positive, but the indirect antiglobulin test using screening blood cells without the Di(a) antigen was negative. After we suspected neonatal hemolytic disease caused by the anti-Di(a) antibody, it was confirmed using selected blood cells containing Di(a) antigen. The newborn and father had DI*A/DI*B and the mother had DI*B. The inclusion of Di(a) antigens in an unexpected antibody screening test should be actively discussed in Korea.

Keyword

Hemolytic disease of newborn; Diego; Hyperbilirubinemia

MeSH Terms

Bilirubin
Blood Cells
Coombs Test
Erythroblastosis, Fetal*
Fathers
Humans
Hyperbilirubinemia
Infant
Infant, Newborn
Korea
Male
Mass Screening*
Mothers
Phototherapy
Bilirubin
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