Hemolytic disease of newborn due to anti-A₁ allo-antibodies: a case report

Hemolytic disease of newborn (HDN) is an alloimmune hemolytic disease which occurs due to red blood type incompatibility between mother and fetus. An AB blood type neonate was admitted to Shengjing hospital with severe anemia. Major crossmatch incompatibility was found with some random donors. Serological tests were administered to the neonate and his parents. The mother was B blood type, while the father was AB blood type. The neonate's direct antiglobulin test (DAT) was negative, but the elution test was positive with A₁ cell and negative with A₂ cell. Titers 64 anti-A₁ and 2 anti-A in the mother's serum were detected after treated by dithiothreitol (DTT). The mother's red cells showed a weak agglutination with anti-A under microscopy. The neonate was diagnosed with HDN. After phototherapy and A₂B red blood cell (RBC) transfusion, the neonate was discharged with a recovery of his hemoglobin and physiological index. This study describes a rare case of HDN caused by anti-A1 allo-antibodies.