Status:
Ready to upload
Record number:
1927
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
First case report of hemolytic disease of the fetus and newborn (HDFN) due to low frequency antigen in the Augustine blood group system.
Time to detection:
In this case male infant was born at 29 weeks gestation with severe HDFN.
Alerting signals, symptoms, evidence of occurrence:
Cord blood direct antiglobulin test 4+, hemoglobin 45 g/L with cardiac failure, pleural effusion, and generalized edema
Demonstration of imputability or root cause:
Clinical signs of HDFN requiring two exchange and four top-up transfusions were required. The maternal antibody was reactive with paternal red blood cells (RBC) and from four additional members of the paternal family. However, extensive testing excluded clinically relevant RBC antibodies but failed to reveal specificity for this antibody. Family DNA study demonstrated that the paternal members had a new low frequency antigen in the Augustine blood group system. A novel assay developed by group demonstrated enhanced binding as reflected by a shift in mean fluorescence intensity for both anti-Ata (antibody to high frequency antigen in the Augustine blood group) and the maternal antibody. This antigen was provisionally numbered as AUG3.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Millard GM, et al. A proposed new low-frequency antigen in the Augustine blood group system associated with a severe case of hemolytic disease of the fetus and newborn. TRANSFUSION 2018;00;00–00
Note:
Please check the adverse occurrence and MPHO type classification (EP) --> modified in Detrimental immunization / plasma (EP)
Expert comments for publication:
First case report of HDFN due to antibody to low frequency antigen in the Augustine blood group system.