Hemolytic disease of the newborn caused by anti-Wright (anti-Wra): case report and review of literature

Neonatal Netw. 2012 Mar-Apr;31(2):69-80. doi: 10.1891/0730-0832.31.2.69.

Abstract

Antibodies to red cell antigens that are found at low frequency in the general population are rare causes of hemolytic disease of the newborn. To understand how to detect these cases, we provide a basic review of routine antenatal maternal antibody testing and report a case of a neonate with severe HDN caused by anti-Wright (anti-Wra), successfully managed with transfusion, phototherapy, and high-dose intravenous immunoglobulin. When hemolysis in a newborn is suspected in the absence of major blood group incompatibility or commonly detected maternal red cell antibodies, a direct antiglobulin test should be performed. A positive DAT should alert the clinician to the presence of maternal antibodies against low-incidence antigens. Antibodies to the Wra antigen are one such rare cause of HDN.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies / analysis*
  • Autoantigens / immunology*
  • Blood Group Antigens / immunology*
  • Blood Group Incompatibility*
  • Erythroblastosis, Fetal / blood
  • Erythroblastosis, Fetal / diagnosis*
  • Erythroblastosis, Fetal / immunology*
  • Exchange Transfusion, Whole Blood
  • Female
  • Flow Cytometry
  • Humans
  • Immunoglobulin G / immunology
  • Infant, Newborn

Substances

  • Antibodies
  • Autoantigens
  • Blood Group Antigens
  • Immunoglobulin G