A Rare Case; Hemolytic Disease of Newborn Associated with [Anti-jk.sup.b]/Nadir Bir Olgu; [Anti-jk.sup.b]'ye Bagli Yenidoganin Hemolitik Hastaligi

• Published in: Güncel pediatri 2015-08, Vol.13 (2), p.127
• Main Authors: Tolunay, Ilknur, Oruc, Meral, Tolunay, Orkun
• Format: Article
• Language: Turkish
• Subjects: Case studies; Diagnosis; Erythroblastosis fetalis; Health aspects; Infants (Newborn); Kidd blood-group system; Pediatric research
• ISSN: 1304-9054
• DOI: 10.4274/jcp.52714

[Jk.sup.a] and [Jk.sup.b] antibodies (Kidd blood group system) can cause acute and delayed type transfusion reactions as well as hemolytic disease of newborn. [Jk.sup.a] and [Jk.sup.b] antibodies are seen after events like blood transfusions, pregnancy, abortion and curettage. Hemolytic disease of newborn related to Kidd-[Jk.sup.b] incompatibility is rare and mostly has a good prognosis. The patient was consulted to our department because of 20 hours of jaundice after birth. He was treated with intensive phototherapy due to the high level of total-value bilirubin (17,6 mg/dl). Mother and patient were both B Rh (+). After direct coombs IgG +++ and C3d ++ values, further investigations were performed and mother had indirect coombs ++ and kidd antigen+. So, the newborn was diagnosed with hemolytic disease of newborn due to kidd incompatibility and was discharged on the fourth day of the treatment without sequel. In the literature serious cases are mentioned, mortality and disabilities are also seen. It is appropriate that pediatricians investigate the subgroup incompatibilities of newborns with hemolytic diseases without ABO and Rh incompatibility in early period, or those of newborns which are having a long respond concerning medical treatment. Keywords [Anti-jk.sup.b], hemolytic, newborn, kidd blood group [Jk.sup.a] ve [Jk.sup.b] antikorlari (Kidd kan grubu sistemi) akut ve gec tip transfuzyon reaksiyonlarina ve yenidoganda hemolitik hastaliga neden olabilirler. [Jk.sup.a] ve [Jk.sup.b] antikorlarina kan transfuzyonlari, gebelik, dusuk, kuretaj gibi olaylar sonrasi rastlanmaktadir. Kidd-[Jk.sup.b] uyumsuzluguna bagli hemolitik hastalik nadir gorulur ve cogunlukla iyi seyirlidir. Bizim hastamiz 20 saatlik sarilik nedeniyle danisilmisti. Toplam bilirubin 17,6 mg/dl olmasi nedeniyle hasta yogun fototerapi ile tedavi edilmeye baslandi. Tetkiklerinde anne ve bebek kan gruplari B grubu Rh + saptanan hastanin direkt coombs IgG +++, C3d ++ gelmesi uzerine yapilan ileri tetkiklerinde annede indirekt coombs ++ ve kidd antijeni + ([Jk.sup.b]) gelmesi uzerine kidd uyumsuzluguna bagli yenidoganin hemolitik hastaligi tanisi konulmus olup hasta tedavinin 4. gununde sekelsiz taburcu edilmistir. Literaturde agir olgularda da mevcut olup sonucunda olum ve sakatlik da gorulebilmektedir. Pediatristlerin ABO ve Rh uyumsuzlugu olmayan erken baslangicli ya da tedaviye yanit uzun suren yenidoganin hemolitik hastaliklarinda subgrup uyumsuzluklarini da dusunmeleri uygun olacaktir. A