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Severe Hemolytic Disease of the Newborn Due to anti-Di^b Treated with Phototherapy and Intravenous Immunoglobulin

Address correspondence to Eun-Jee Oh, M.D., Department of Laboratory Medicine, College of Medicine, Catholic University of Korea, 505 Banpo-dong Seocho-ku, Seoul, 137–040, Korea (South); tel 82 2 590 2221; fax 82 2 590 2547; e-mail ejoh{at}catholic.ac.kr.

The Di^b antigen usually occurs with high incidence, except in certain Asian and South American Indian populations. In general, hemolysis caused by anti-Di^b is not severe and its clinical course is benign. We report a Korean neonate with severe hemolytic disease of the newborn caused by anti-Di^b. The phenotype and genotype of the Diego blood group system of the patient and his mother were Di(a+b+) and Di(a+b–), respectively. The mother’s serum and eluate from the neonate’s erythrocytes contained anti-Di^b. This case was successfully managed with phototherapy and high dose iv immunoglobulin. Since most commercial antibody detection panels do not contain Di(b-) red cells, it is important to consider anti-Di^b in cases of hemolytic disease of the newborn caused by an antibody against a high frequency antigen.

Keywords: anti-Di^b, hemolytic disease of the newborn, Diego blood group, phototherapy, iv IgG