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Case Report
 
Severe hemolytic disease of the fetus due to anti-Kpa antibody
Karen Q Rossi1, Scott Scrape2, Christopher Lang3, Richard O'Shaughnessy4
1BSN, MA, Clinical Instructor, Department of Maternal Fetal Medicine, Wexner Medical Center at The Ohio State University, Columbus OH, USA.
2MD, Assistant Professor, Department of Pathology, Wexner Medical Center at The Ohio State University, Columbus OH, USA.
3MD, Assistant Professor, Department of Maternal Fetal Medicine, Wexner Medical Center at The Ohio State University, Columbus OH, USA.
4MD, Professor, Department of Maternal Fetal Medicine, Wexner Medical Center at The Ohio State University, Columbus OH, USA.

Article ID: 100012IJBTIKQR2013

doi:10.5348/ijbti-2013-12-CR-3

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Karen Q Rossi
395 West 12th Avenue
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USA. 43210
Phone: 614-293-8083
Fax: 614-293-1523
Email: rossi.34@osu.edu

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How to cite this article:
Rossi KQ, Scrape S, Lang C, O'Shaughnessy R. Severe hemolytic disease of the fetus due to anti-Kpa antibody. International Journal of Blood Transfusion and Immunohematology 2013;3:19–22.


Abstract
Introduction: Anti-Kpa antibodies are an uncommon cause of hemolytic disease of the fetus and newborn (HDFN). Screening for antibodies to low frequency antigens such as Kpa is not routine, so detecting them can present a challenge.
Case Report: We report a case of hydropic HDFN due to anti-Kpa antibodies discovered incidentally with direct antiglobulin testing of a fetal blood sample in the course of work-up and treatment for presumed acute parvovirus B19 induced hydrops fetalis. Six intrauterine red blood cell transfusions and one simple neonatal red blood cell transfusion were required.
Conclusion: The cause of fetal anemia needs to be properly diagnosed in order to provide appropriate clinical care in affected pregnancies. Sensitization from uncommon antigens is more difficult to diagnose due to the lack of routine screening. This case illustrates the importance of performing direct antiglobulin testing on fetal blood before intrauterine transfusion in any case of fetal anemia despite presumed alternative etiologies.

Keywords: Anti-Kpa antibody, Hemolytic disease of the fetus and newborn (HDFN), Direct antiglobulin test (DAT), Hydrops fetalis, Alloimmunization


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Author Contributions
Karen Q Rossi – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Scott Scrape – Drafting the article, Critical revision of the article, Final approval of the version to be published
Christopher Lang – Drafting the article, Critical revision of the article, Final approval of the version to be published
Richard O'Shaughnessy – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
Copyright
© Karen Q Rossi et al. 2013; This article is distributed the terms of Creative Commons attribution 3.0 License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)