Hemolytic disease of the fetus and newborn occurs when maternal IgG antibodies cross the placenta and cause hemolysis of fetal red blood cells. Kp a is a low frequency red blood cell antigen that has rarely been implicated in hemolytic disease of the fetus and newborn. The few reported cases attributed to anti-Kp a have typically had minimal clinical consequences. We report a critically ill neonate who presented with purpura, respiratory failure, severe liver dysfunction, hyperbilirubinemia, hypoglycemia and anemia. This case report broadens the spectrum of neonatal disease associated with anti-Kp a, addresses the evaluation of hemolysis with liver failure in a neonate, and emphasizes the importance of screening for antibodies to low frequency red blood cell antigens in suspected hemolytic disease of the fetus and newborn.
Bibliographical noteFunding Information:
Drs Beck, Bendel, Brumbaugh, Kearney, Morgan and Roberts declare no conflict of interests. Dr Zantek’s work has been funded in part by a research grant from Verax Biomedical, Inc., and she has received royalties from MedImmune.
- blueberry muffin rash
- extramedullary hematopoiesis
- hemolytic disease of the fetus and newborn