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Am J Perinatol 2008; 25(9): 541-545
DOI: 10.1055/s-0028-1085072
© Thieme Medical Publishers

Hemolytic Disease of the Fetus and Newborn Due to Anti-Ge3: Combined Antibody-Dependent Hemolysis and Erythroid Precursor Cell Growth Inhibition

Douglas P. Blackall1 , Gina D. Pesek1 , Matthew M. Montgomery1 , Krishna K. Oza1 , Patricia A. Arndt2 , George Garratty2 , Ali Shahcheraghi3 , Gregory A. Denomme3
  • 1University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas
  • 2American Red Cross Blood Services, Pomona, California
  • 3Mount Sinai Hospital, University of Toronto and Canadian Blood Services, Toronto, Canada
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Publication History

Publication Date:
21 August 2008 (online)

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ABSTRACT

The Gerbich (Ge) antigens are a collection of high-incidence antigens carried on the red blood cell membrane glycoproteins, glycophorins C and D. Antibodies against these antigens are uncommon, and there have been only rare case reports of hemolytic disease of the fetus and newborn due to anti-Ge. In this case report, we present a neonate with severe anemia and hyperbilirubinemia due to anti-Ge3. Routine and special laboratory studies undertaken in this case suggested two mechanisms for the patient's hemolysis and persistent anemia. Antibody-dependent hemolysis was associated with early-onset hyperbilirubinemia, anemia, and a mild reticulocytosis, and inhibition of erythroid progenitor cell growth was associated with late anemia and normal bilirubin and reticulocyte values. Though rare, anti-Ge3 can be a dangerous antibody in pregnancy. Affected neonates may require intensive initial therapy and close follow-up for at least several weeks after delivery.

KEYWORDS

Gerbich - hemolysis - hemolytic disease of the newborn - red blood cells

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Douglas P BlackallM.D. 

Department of Pathology, Arkansas Children's Hospital

800 Marshall Street, Little Rock, AR 72202

Email: blackalldouglasp@uams.edu