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Clinical and Experimental Obstetrics & Gynecology  2018, Vol. 45 Issue (4): 549-551    DOI: 10.12891/ceog4480.2018
Original Research Previous articles | Next articles
HLA-DQB1*0201 phenotype and severe primary RhD immunization
A. Giancotti1, A. Pizzuti2, V. D'Ambrosio1, 2, *(), A. De Filippis1, F. Vena1, M. G. Piccioni1, R. D'Amelio1, R. Brunelli1
1 Department of Gynecological, Obstetrical and Urological Sciences, University of Rome "Sapienza", Policlinico Umberto I Hospital, Rome, Italy
2 Department of Experimental Medicine, University of Rome "Sapienza", Policlinico Umberto I Hospital, Rome, Italy
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Purpose of Investigation: Although post-delivery administration of anti-D immunoglobulin (anti-D Ig) and antenatal prophylaxis the residual prevalence of RH alloimmunization is due to an incomplete application of the guidelines or to clinical conditions that foster mechanisms of immunization. Materials and Methods: The authors report a case of devastating RhD alloimmunization in a secundipara, group 0 Rh negative, without potentially immunizing events. Results: Anti-D antibodies were screened at 6/2 and at 13/4 weeks and were found negative. Fetal echocardiography at 25/0 weeks showed dilated right cardiac sections and a mild pericardial effusion. Titer of anti-D antibodies was (1:1024) with negative Kleihauer-Betke. At 27/0 weeks she had an increase of anti-D antibody titer (1:8192), peak systolic velocity in the middle cerebral artery suggested severe fetal anemia. A positive HLA-DQB1 allele *0201 was found, and she gave birth to an infant with severe immune-mediated hemolysis (HB: 3.8 g/dl) who was discharged 62 days after birth due to perinatal complications. Conclusion: HLA-DQB1*0201 phenotyping can improve the surveillance and treatment of non-sensitized D negative patients.
Key words:  Anti-D immunoglobulin (anti-D Ig)      Rh negative      Phenotyping     
Published:  10 August 2018     
*Corresponding Author(s):  V. D'AMBROSIO     E-mail:

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A. Giancotti, A. Pizzuti, V. D'Ambrosio, A. De Filippis, F. Vena, M. G. Piccioni, R. D'Amelio, R. Brunelli. HLA-DQB1*0201 phenotype and severe primary RhD immunization. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(4): 549-551.

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