Hemolytic disease of the newborn (HDN) arising from MNSs incompatibility is rare, with few reports of prolonged anemia and reticulocytopenia following HDN. We report the younger of 2 male siblings, both of whom had anti-M-induced HDN and anemia persisting for over a month. Peripheral reticulocytes remained inappropriately low for the degree of anemia, and they needed multiple red cell transfusions. Viral infections were ruled out. Corticosteroids were given for suspected pure red cell aplasia. Anemia and reticulocytopenia subsequently improved. Colony-forming unit erythroid assay revealed erythropoietic suppression of M antigen-positive erythroid precursor cells cultured with maternal or infant sera containing anti-M. In conclusion, maternal anti-M caused HDN and prolonged anemia by erythropoietic suppression in 2 siblings.
*Department of Pediatrics
‡Division of Central Laboratories, Gifu Prefectural Tajimi Hospital, Gifu
†Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima
§Japanese Red Cross Hokkaido Block Blood Center, Hokkaido, Japan
Parental consent was granted for all tests.
The authors declare no conflict of interest.
Reprints: Atsushi Ishida, MD, Department of Pediatrics, Gifu Prefectural Tajimi Hospital, 5-161, Maehata-cho, Tajimi City, Gifu 507-8522, Japan (e-mail: email@example.com).
Received September 19, 2014
Accepted March 26, 2015