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Anti-Fy a is a common antibody while anti-Fy b is approximately 20 times less common., [106] [107] They are reactive at body temperature and are therefore clinically significant, although they do not typically bind complement. Antibodies are acquired through exposure (pregnancy or history of blood transfusion) and subsequent alloimmunization.
Mothers who are negative for the Kell 1 antigen develop antibodies after being exposed to red blood cells that are positive for Kell 1. Over half of the cases of hemolytic disease of the newborn owing the anti-Kell antibodies are caused by multiple blood transfusions, with the remainder due to a previous pregnancy with a Kell 1 positive baby.
The main types are ABO HDN, Rhesus HDN, Kell HDN, and other antibodies. Combinations of antibodies (for example, anti-Rhc and anti-RhE occurring together) can be especially severe. [citation needed] ABO hemolytic disease of the newborn can range from mild to severe, but generally, it is a mild disease. It can be caused by anti-A and anti-B ...
An indirect coombs needs to be run in cases of anti-C, [13] anti-c, [13] and anti-M. Anti-M also recommends antigen testing to rule out the presence of HDN. [26] Hgb - the infant's hemoglobin should be tested from cord blood. [1] Reticulocyte count - Reticulocytes are elevated when the infant is producing more blood to combat anemia. [1]
The anti-RhE antibody can be naturally occurring, or arise following immune sensitization after a blood transfusion or pregnancy. The anti-RhE antibody is quite common especially in the Rh genotype CDe/CDe; it usually only causes a mild hemolytic disease, but can cause a severe condition in the newborn.
The direct Coombs test is used to detect antibodies or complement proteins attached to the surface of red blood cells. To perform the test, a blood sample is taken and the red blood cells are washed (removing the patient's plasma and unbound antibodies from the red blood cells) and then incubated with anti-human globulin ("Coombs reagent").
Coombs - after birth, the newborn will have a direct Coombs test run to confirm antibodies attached to the infant's red blood cells. This test is run from cord blood. [5] In some cases, the direct Coombs will be negative but severe, even fatal HDN can occur. [15] An indirect Coombs needs to be run in cases of anti-C, [16] anti-c, [16] or anti-M ...
Blood compatibility testing is routinely performed before a blood transfusion.The full compatibility testing process involves ABO and RhD (Rh factor) typing; screening for antibodies against other blood group systems; and crossmatching, which involves testing the recipient's blood plasma against the donor's red blood cells as a final check for incompatibility.