Nadir bir olgu; anti-jkb’ye bağlı yenidoğanın hemolitik hastalığı
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Date
2014-06-13
Authors
Tolunay, İlknur
Oruç, Meral
Tolunay, Orkun
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Jka ve Jkb antikorları (Kidd kan grubu sistemi) akut ve geç tip transfüzyon reaksiyonlarına ve yenidoğanda hemolitik hastalığa neden olabilirler. Jka ve Jkb antikorlarına kan transfüzyonları, gebelik, düşük, küretaj gibi olaylar sonrası rastlanmaktadır. Kidd-Jkb uyumsuzluğuna bağlı hemolitik hastalık nadir görülür ve çoğunlukla iyi seyirlidir. Bizim hastamız 20 saatlik sarılık nedeniyle danışılmıştı. Toplam bilirubin 17,6 mg/dl olması nedeniyle hasta yoğun fototerapi ile tedavi edilmeye başlandı. Tetkiklerinde anne ve bebek kan grupları B grubu Rh + saptanan hastanın direkt coombs IgG +++, C3d ++ gelmesi üzerine yapılan ileri tetkiklerinde annede indirekt coombs ++ ve kidd antijeni + (jkb) gelmesi üzerine kidd uyumsuzluğuna bağlı yenidoğanın hemolitik hastalığı tanısı konulmuş olup hasta tedavinin 4. gününde sekelsiz taburcu edilmiştir. Literatürde ağır olgularda da mevcut olup sonucunda ölüm ve sakatlık da görülebilmektedir. Pediatristlerin ABO ve Rh uyumsuzluğu olmayan erken başlangıçlı ya da tedaviye yanıt uzun süren yenidoğanın hemolitik hastalıklarında subgrup uyumsuzluklarını da düşünmeleri uygun olacaktır.
Jka and Jkb antibodies (Kidd blood group system) can cause acute and delayed type transfusion reactions as well as hemolytic disease of newborn. Jka and Jkb antibodies are seen after events like blood transfusions, pregnancy, abortion and curettage. Hemolytic disease of newborn related to Kidd-Jkb incompatibility is rare and mostly has a good prognosis. The patient was consulted to our department because of 20 hours of jaundice after birth. He was treated with intensive phototherapy due to the high level of total-value bilirubin (17,6 mg/dl). Mother and patient were both B Rh (+). After direct coombs IgG +++ and C3d ++ values, further investigations were performed and mother had indirect coombs ++ and kidd antigen+. So, the newborn was diagnosed with hemolytic disease of newborn due to kidd incompatibility and was discharged on the fourth day of the treatment without sequel. In the literature serious cases are mentioned, mortality and disabilities are also seen. It is appropriate that pediatricians investigate the subgroup incompatibilities of newborns with hemolytic diseases without ABO and Rh incompatibility in early period, or those of newborns which are having a long respond concerning medical treatment.
Jka and Jkb antibodies (Kidd blood group system) can cause acute and delayed type transfusion reactions as well as hemolytic disease of newborn. Jka and Jkb antibodies are seen after events like blood transfusions, pregnancy, abortion and curettage. Hemolytic disease of newborn related to Kidd-Jkb incompatibility is rare and mostly has a good prognosis. The patient was consulted to our department because of 20 hours of jaundice after birth. He was treated with intensive phototherapy due to the high level of total-value bilirubin (17,6 mg/dl). Mother and patient were both B Rh (+). After direct coombs IgG +++ and C3d ++ values, further investigations were performed and mother had indirect coombs ++ and kidd antigen+. So, the newborn was diagnosed with hemolytic disease of newborn due to kidd incompatibility and was discharged on the fourth day of the treatment without sequel. In the literature serious cases are mentioned, mortality and disabilities are also seen. It is appropriate that pediatricians investigate the subgroup incompatibilities of newborns with hemolytic diseases without ABO and Rh incompatibility in early period, or those of newborns which are having a long respond concerning medical treatment.
Description
Keywords
Anti-jkb, Hemolitik, Yenidoğan, Kidd kan grubu, Hemolytic, Newborn, Kidd blood group
Citation
Tolunay, İ. vd. (2015). "Nadir bir olgu; anti-jkb’ye bağlı yenidoğanın hemolitik hastalığı". Güncel Pediatri, 13(2), 127-130.