Variable manifestations of minor blood group incompatibility

Abstract

In settings with adequate coverage of anti-D immunoglobulin, minor blood group incompatibility has become an important cause of hemolytic disease of the newborn (HDN). We presented a series of cases of HDN of varying severities caused due to presence of anti-E and anti-C antibodies. Two neonates with anti-E antibodies developed jaundice requiring intensive phototherapy, while the course of the third neonate born to mother with Rh D isoimmunization was complicated by presence of anti-C antibodies, who needed double volume exchange transfusions for jaundice and packed red cell transfusions for anemia. Hearing screening and neurological examination at discharge were normal for all three neonates. These cases highlighted the need for appropriate testing for minor blood group incompatibility in unusual cases of HDN to initiate timely therapy and prevent neonatal morbidity and mortality.