Status:
Ready to upload
Record number:
1977
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
This is a case report of an infant born to a mother with a previous history of infants suffering hemolytic disease of the newborn and laboratory evidence of anti-D. The infant, D-positive, underwent intra- uterine transfusions and exchange transfusions. He receive breast milk feedings and developed anemia and hyperbilrubinemia. Evaluation of maternal breast milk revealed high titer IgG anti-D. No direct evidence presented that the baby absorbed this antibody through the gastrointestinal tract, although clinical course supports this hypothesis. Authors indicate this is an extremely rare reported event.
Time to detection:
Anemia and bilirubin increase detected 4-6 weeks after birth.
Alerting signals, symptoms, evidence of occurrence:
Anemia and hyperbilirubinemia following birth in an infant with HDN, but for which etiology of new bilirubin elevations was uncertain.
Demonstration of imputability or root cause:
Laboratory evaluation of maternal breast milk demonstating high tier IgG anti-D alloantibodies.
Imputability grade:
2 Probable
Groups audience:
Keywords:
Reference attachment:
Suggest references:
Persistent hemolytic disease of the fetus and newborn (HDFN) associated with passive acquisition of anti-D in maternal breast milk.
Expert comments for publication:
Case report of an infant with hemolytic disease of the fetus and newborn treated with intrauterine transfusions and exchange transfusions, but subsequently developing hyperbilirubinemia attributed to passively acquired anti-D absorbed through the g.i. tract via breast milk feedings containing high titer anti-D.