母視Anti-E不規則抗體引起的新生兒溶血性疾病：一病例報告

Hemolytic Disease of the Newborn Caused by Maternal Irregular Antibody Anti-E: Report of One Case

劉義仁(Yi-Jen Liu) ； 李碧峯(Bee-Fung Lee) ； 林應然(Yung-Zen Lin) ； 陳偉德(Walter Chen) ； 吳康文(Kang-Wen Wu) ； 林媽利(Marie-Chu Lin)

《Acta Paediatrica Sinica》 31卷5期 (1990/10) Pp. 332-335

摘要

病嬰是第三胎男嬰，足月，自然生産，産程順利，出生體重3390公克，理學檢查無特殊異常，但出生後15小時就出現明顯黃疸，膽紅素高達21mg/dl。母親過去無輸血記錄且前兩胎皆正常，其與嬰兒皆爲A型Rh(D)陽性，在凖備換血時，所領取的A型新鮮全血與母子二人血液分別作交叉試驗，結果皆出現凝集反應（即不配合），作不規則抗體篩檢時二者也皆呈陽性反應。經做數袋血之交叉試驗後終於取得適合之A型血液後，病嬰經過兩次換血治療，黃㡺才獲改善，此後病情逐漸穩定，一週後出院，現仍於健兒門診追蹤。母親與嬰兒之血液檢體經送往馬偕醫院血庫作進一步鑑定，證實該不規則抗體是anti-E，母親紅血球phenotyping爲CCDee(R1R1)，嬰兒CcDEe(R1R2)。

並列摘要

A 3390 gm male baby was born smoothly at 41 weeks’ gestation to a 35-year-old, gravnal 3, para 3, mother by spontaneous vaginal delivery at this hospital. The mother denied ever having received a blood transfusion. Her first two uneventful pregnancies had resulted in two healthy fullterm infants.
Physical examination of the baby showed normal, until 15 hours of age, when apparent jaundice with serum total bilirubin concentration up to 21 mg/dl was noted. The blood types of both baby and mother were group A, Rh(D) positive. Compatibility testing for exchange blood transfusion with group A whole blood showed positive reaction due to the presence of an irregular antibody. Two exchange blood transfusions were performed in the same day with compatible blood.
Thereafter, the patient’s condition was much improved, he was discharged one week later. The irregular antibody-anti-E was identified in both baby and mother. The maternal RBC phenotyping was CCDee (R1R1), and the baby, CcDEe (R1R2).

並列關鍵字

hemolytic disease of the newborn ； anti-E antibody