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PubMed1998

[A case of ABO blood group incompatibility treated by exchange transfusion].

A patient with ABO blood group incompatibility who was treated by exchange transfusion is reported. A 63-year-old woman with blood group B type Rh (+) was accidentally transfused approximately 120 ml of A type Rh (+) packed red cells. She developed shock state, complaining chilliness, trepidation, nausea and vomiting just after the atypical blood transfusion. Fortunately, we could save her life without any complication by doing exchange transfusion in addition to anti-shock therapy and anticoagulant therapy preventing disseminated intravascular coagulation. The exchange transfusion was performed while monitoring central venous pressure. The total withdrawn blood reached 4300 ml, and 18 units of B type Rh (+) packed red cells, 10 units of AB type Rh (+) fresh frozen plasmas, 1250 ml of plasma protein fractions and 1750 ml of plasma expanders were infused with crystalloid fluid therapy. Although the amount of atypical blood transfusion to her was relatively small, it is considered that the exchange blood transfusion which seems to be only the fundamental therapy against atypical blood transfusion, took effect in saving her life without any complication.

ABO Blood-Group System↗
PubMed1991

[Neonatal blood group incompatibility due to anti-M antibodies].

Neonatal blood group antagonism due to anti-M antibodies is extremely rare. The case is reported of a neonate with moderately severe haemolytic anaemia due to anti-M which required two blood transfusions. Although anti-M antibodies are as a rule regarded as clinically irrelevant, and although they react almost exclusively at lower temperatures, they may in exceptional cases be demonstrated at 37 degrees C, as in the patient described; they may then cause haemolysis. Most strikingly, the direct Coombs test in this patient was negative; this phenomenon has been described before. In unexplained haemolytic anaemia of a newborn, even in the presence of a negative direct Coombs test, the possibility of blood group antagonism should be considered.

Anemia, Hemolytic, Congenital↗
PubMed1982

Bone marrow transplantation with major ABO blood group incompatibility using erythrocyte depletion of marrow prior to infusion.

Twenty-five patients with major ABO blood group incompatibility between donor and recipient underwent allogeneic bone marrow transplantation using erythrocyte depletion of the bone marrow infusate prior to administration. Over 95% of the original erythrocyte content of the marrows was removed, while retaining 75% of the mononuclear cell content and 57% of the granulocyte-monocyte colony-forming units. Recipients, well hydrated and premedicated with corticosteroids, diphenhydramine, and mannitol, tolerated infusions well. The frequency of engraftment, rate of recovery of peripheral blood leukocytes, granulocytes, and platelets, and the incidence of graft-versus-host disease was similar to that observed following ABO blood group compatible bone marrow transplantation. Erythroid development following ABO blood group incompatible transplantation was significantly impaired until hemagglutinins fell to 1:4 or lower, at which time recovery of erythrocytes was detected in the peripheral blood. The erythrocyte hypoplasia associated with incompatible hemagglutinins was temporary. Erythrocyte purging is a safe and effective technique to perform bone marrow transplantation across major ABO blood group incompatibilities.

ABO Blood-Group System↗
PubMed1985

Familial occurrence of hemolytic disease of the newborn due to AO blood group incompatibility.

The extent of the familial occurrence of hemolytic disease of the newborn due to AO blood group incompatibility between mother and fetus was examined. The records of all families in which the mother had blood group O and two or more babies had blood group A, with one of them having been born at Women & Infants Hospital of Rhode Island in the index year of 1979, were examined. Eighty-nine of these families fulfilled criteria intended to exclude causes of hyperbilirubinemia other than AO blood group incompatibility. The peak bilirubin level in each infant was graded as normal, elevated, or severely elevated. The relations between birth order and peak bilirubin level, between peak bilirubin levels in the first and second babies in each family, and between gestational age and peak bilirubin level were assessed. The first two of these relations showed effects at the 0.10 and 0.05 significance levels, respectively. It is concluded that the risk of hyperbilirubinemia attributable to AO blood group incompatibility is greater for the second than for the first baby at risk in a sibship, that the risk is yet greater for the second if the first was also affected, and that, in the latter case, there is also increased risk of marked hyperbilirubinemia.

ABO Blood-Group System↗
PubMed1998

Prevention of maternal-fetal blood group incompatibility with traditional Chinese herbal medicine.

OBJECTIVE: To evaluate the effect of traditional Chinese herbal medicine on the prevention of hemolytic disease caused by maternal-fetal blood group incompatibility. METHODS: A total of 126 Chinese patients with maternal-fetal blood group incompatibility were studied, including 105 cases of ABO type and 21 cases of Rh type incompatibility. The traditional Chinese herbal medicine was used for preventative treatment in 79 cases, and 47 cases served as controls. The prescription consisted of Herba leonuri 500 g, white peony root 180 g, Banksia rose 12 g, root of Chinese angelica 150 g and Rhizomal ligustica 150 g. RESULTS: Preventative treatment with traditional Chinese herbal medicine significantly reduced the perinatal mortality rate in cases of Rh type incompatibility, from 50.0% in the control group to 7.7% in the treatment group (P < 0.05). There was no death in the cases of ABO incompatibility. The traditional Chinese herbal medicine also decreased the degree of hemolysis. The percentage of severe cases in the control group was 29.8%, while it was 15.2% in the treatment group (P = 0.05). The duration of treatment was closely related to the outcomes. In patients who used traditional Chinese herbal medicine for more than 10 weeks, the incidence of severe hemolysis was 8.2%, compared with 38.9% in those treated for less than 10 weeks (P < 0.05). The change of serum immune antibody (A and/or B) titers during the treatment was a very important predictive factor for the outcome of the pregnancy. CONCLUSION: Traditional Chinese herbal medicine is effective not only for ABO type but also for Rh type maternal-fetal blood group incompatibility, with no side effects.

ABO Blood-Group System↗
PubMed1994

Removal of maternal antibodies from a woman with repeated fetal loss due to P blood group incompatibility.

BACKGROUND: Plasmapheresis is intended to lower plasma antibody levels in women with blood group incompatible pregnancies. CASE REPORT: Therapeutic specific antibody removal by using antigen-positive red cells was applied to a blood group p pregnant women who had a high titer (128) of IgG anti-PP1Pk and had lost all six previous fetuses in blood group P-incompatible pregnancies. Plasma was taken from the patient with an intermittent-flow cell separator, mixed with a volume of washed and packed P-positive red cells equivalent to one-fifth of the volume of plasma, and incubated for 10 minutes in an ice water bath. The PP1Pk antibodies were removed, and the autologous plasma was transfused. Treatment by specific antibody removal was started in the seventh week of gestation, and performed one to three times a week for a total of 56 times up to the 34th week. The volume of plasma treated was 2.4 L per procedure on average and totaled 135 L. After each treatment, the antibody titer in the patient's plasma usually decreased by 1 log2, and no deleterious effect on the women was noted. The titers of IgG anti-P and anti-Pk were kept between 4 and 16 after the ninth week of gestation. At the end of the 34th week of gestation, a male infant was delivered by cesarean section. The infant did not require an exchange transfusion and is now a healthy 2-year-old boy. CONCLUSION: This therapeutic method is very useful in the management of fetomaternal P-incompatibility.

Abortion, Habitual↗
PubMed1978

Blood group incompatibility and cervical hostility in relation to sterility.

Fifty-two sterile couples, characterized by persistent and unexplained incompatibility between spermatozoa and cervical mucus, without any other evident factor to explain their sterility, were investigated for the possible role of blood group incompatibility as a cause of their sterility. After a study of the distribution of blood groups in sterile and fertile couples, the distribution of blood group substances in pairs of husbands and wives, and the effect of blood group antibodies on sperm migration, it seems highly unlikely that blood group incompatibility contributes significantly to cervical hostility and the resulting sterility.

ABO Blood-Group System↗
PubMed1992

Maternal-child blood group incompatibility and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus.

The nationwide Swedish Childhood Diabetes Registry, which ascertains 99% of recent-onset Type 1 (insulin-dependent) diabetic children (0-14 years) in Sweden, was linked with the Swedish Medical Birth Registry. A matched case-control study was carried out analysing about 20 perinatal variables concerning mother and child. A total of 2757 infants who became diabetic during the period 1978-1988 were analysed. For each case infant three control children were randomly selected from among all infants born in the same year and at the same delivery unit as the case infant. The following statistically significant risk factors were identified for Type 1 diabetes with an onset before 15 years of age: maternal diabetes (OR = 3.90), maternal age above 35 (OR = 1.36), maternal non-smoking (OR = 1.54), pre-eclamptic toxaemia (OR = 1.19), caesarian section (OR = 1.32), and maternal-child blood group incompatibility (OR = 1.61). When the analysis was restricted to Type 1 diabetes with an onset before the age of 5 years, most odds ratios were increased - for blood group incompatibility OR = 3.86 (95% confidence interval 1.54-9.65). Icterus without blood group incompatibility was not a significant risk factor. When each risk factor was analysed after standardization for all other risk factors, the odds ratios remained significantly increased. Scrutiny of medical records for cases and control children with a diagnosis of blood group incompatibility verified the diagnosis in close to 90% of children. The more severe cases needing phototherapy and/or blood transfusion were found to have a greater risk than milder cases.(ABSTRACT TRUNCATED AT 250 WORDS)

ABO Blood-Group System↗
PubMed1991

High-dose intravenous gammaglobulin therapy for neonatal immune haemolytic jaundice due to blood group incompatibility.

Three newborn infants who developed hyperbilirubinemia due to blood group incompatibility were treated with high-dose gammaglobulin. Hyperbilirubinemia was caused by Rhesus (Rh) incompatibility (anti-E + anti-c) in Infant 1 and ABO incompatibility (anti-B) in Infants 2 and 3. Hyperbilirubinemia was refractory to conventional phototherapy but responded well to intravenous gammaglobulin (IVGG) at a dose of 1 g/kg in all infants. No adverse effects were observed. These findings suggest that high-dose IVGG may be useful in the treatment of hyperbilirubinemia due to isoimmune haemolytic disease resistant to phototherapy.

Drug Combinations↗