RESUMO
OBJECTIVE: To evaluate the influence of fetal hydrops and other variables on fetal hematocrit (Hct) decrease after the first intrauterine transfusion (IUT) in alloimmunized pregnancies. METHODS: From 1996 to 2006, the data of all alloimmunized pregnancies submitted to IUT were assessed. Exclusion criteria included: fetuses submitted to intraperitoneal transfusion; pregnancies complicated by other fetal abnormalities; pregnancies submitted to only one IUT, and cases in which posttransfusion or pretransfusion blood samples were not obtained. Linear regression models were implemented to assess the relationship between the rate of Hct fall after the first IUT and the following variables: fetal hydrops; antibody titer; gestational age at the first IUT; number of days between the first and second IUT; pretransfusion and posttransfusion fetal Hct values. RESULTS: Fifty fetuses fulfilled the study criteria. The fetal Hct decrease after the first IUT was 1.21 (range 0.18-2.3) %/day. The variables independently associated with the fetal Hct drop after the first IUT were the fetal hydrops (p = 0.000), the pretransfusion fetal Hct (p = 0.001) and the posttransfusion fetal Hct (p = 0.016). CONCLUSION: Fetal hydrops, pretransfusion fetal Hct and posttransfusion fetal Hct seem to influence the fetal Hct decrease between the first and second IUT. These findings may be helpful for estimating the rate of fetal Hct drop and programming the following IUT.
Assuntos
Anemia Hemolítica/terapia , Transfusão de Sangue Intrauterina , Eritrócitos/imunologia , Hidropisia Fetal/sangue , Hidropisia Fetal/terapia , Anemia Hemolítica/etiologia , Feminino , Sangue Fetal , Hematócrito , Humanos , Isoantígenos , Sistema do Grupo Sanguíneo Kidd/imunologia , Antígenos do Grupo Sanguíneo de Lewis/imunologia , Modelos Lineares , Gravidez , Estudos Retrospectivos , Isoimunização RhAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Sistema do Grupo Sanguíneo Kidd/genética , Sistema do Grupo Sanguíneo Kidd/história , Sistema do Grupo Sanguíneo Kidd/imunologia , Isoantígenos , Isoanticorpos , Fenótipo , Tipagem e Reações Cruzadas Sanguíneas , Testes Sorológicos , Transfusão de Sangue/efeitos adversos , Etnicidade/genéticaAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Isoantígenos , Sistema do Grupo Sanguíneo Kidd/genética , Sistema do Grupo Sanguíneo Kidd/história , Sistema do Grupo Sanguíneo Kidd/imunologia , Tipagem e Reações Cruzadas Sanguíneas , Etnicidade/genética , Isoanticorpos , Fenótipo , Testes Sorológicos , Transfusão de Sangue/efeitos adversosRESUMO
BACKGROUND: Primary immune response against red blood cell (RBC) antigens often takes weeks or months to be detected. In previous reports, for children receiving multiple units of blood components, ranging from five to 81 units, the elapsed time between the first RBC transfusion and antibody detection ranged from 18 to 78 days. Cytomegalovirus (CMV) is sometimes associated with immunohaematologic findings and may modulate immune response. CASE REPORT: A 24-week-old male infant with interstitial pneumonia and hepatitis because of CMV developed an RBC auto antibody and two RBC alloantibodies: anti-Jka, detected in tube 11 days after a single RBC transfusion, and anti-K, detected only in papain gel test 18 days later. CONCLUSION: As anti-Jka is not a naturally occurring antibody, this is the most rapid primary immune response against an RBC antigen after a single RBC transfusion ever described, in the youngest child ever described.