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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 614-616    DOI: 10.31083/j.ceog.2020.04.4267
Case Report Previous articles | Next articles
Anti-E alloimmunization in a pregnancy with a low antibody titer
K. Nakanishi1, Y. Oishi1, T. Miyamoto2, *(), E. Nakamura3, K. Murakami1, M. Ono1, A. Nozawa1, S. Kitamura1, K. Sengoku2
1Department of Obstetrics and Gynecology, Nayoro City General Hospital, Nayoro, Japan
2Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
3Department of Pediatrics, Nayoro City General Hospital, Nayoro, Japan
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Abstract  

Red blood cell alloimmunization during pregnancy causes hemolytic disease of the fetus and newborn. While alloimmunization in pregnancy is treatable with anti-D antibodies, management with other antibodies has not been studied. A 32-year-old woman had anti-E antibodies detected during pregnancy, but the titer was < 1 : 2. Her newborn was admitted to hospital because direct Coombs tests were positive. Low titers of maternal anti-E antibodies were found in the newborn. We performed phototherapy and administered intravenous immunoglobulin because the newborn showed early jaundice and hyperkalemia, which suggested hemolytic disease. After being discharged at 6 days of age, the baby was readmitted to hospital at 9 days because of recurrent jaundice and underwent phototherapy. The baby was later discharged without recurrence of jaundice. Low anti-E antibody titers in pregnancy can cause alloimmunization, which can be treated successfully. The potential risk of hemolytic disease should be considered in cases with such low titers.

Key words:  Alloimmunization      Anti-E antibody      Hemolytic disease of the fetus and newborn      Pregnancy      Rho(D) immunoglobulin.     
Submitted:  29 March 2017      Accepted:  31 May 2017      Published:  15 August 2020     
*Corresponding Author(s):  T. Miyamoto     E-mail:  toshim@asahikawa-med.ac.jp

Cite this article: 

K. Nakanishi, Y. Oishi, T. Miyamoto, E. Nakamura, K. Murakami, M. Ono, A. Nozawa, S. Kitamura, K. Sengoku. Anti-E alloimmunization in a pregnancy with a low antibody titer. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 614-616.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.4267     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/614

Figure 1.  — Neonatal clinical course and treatment regimen showing changes in hemoglobin, total bilirubin, and potassium levels. IVIG, intravenous immunoglobulin therapy

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