ABO blood group incompatibility between mother and fetus can lead to hemolytic disease of the fetus and newborn (HDFN). We present the first case of severe O/A HDFN associated with extremely high-titer (1:32 000) immunoglobulin G anti-A antibodies in a Cameroon mother. Cord blood analysis revealed severe fetal hemolytic anemia and conjugated hyperbilirubinemia. After exclusion of an underlying disease and other risk factors, cholestasis resolved after treatment with ursodeoxycholic acid, a red blood cell transfusion, and intravenous immunoglobulins. This case is presented to create awareness for a more severe course of ABO HDFN in nonwhite and non-European mother-child pairs.

Additional Metadata
Persistent URL dx.doi.org/10.1542/peds.2018-2859, hdl.handle.net/1765/116109
Journal Pediatrics (English Edition)
Citation
Zonneveld, R., van der Meer-Kapelle, L., Sylva, M., Brand, A, Zijlstra, M, & Schonewille, H. (2019). Severe Fetal Hemolysis and Cholestasis Due to High-Titer Maternal IgG Anti-A Antibodies. Pediatrics (English Edition), 143(4). doi:10.1542/peds.2018-2859