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Mild haemolytic disease of fetus and newborn due to anti-Ge3

Background: The rare Gerbich (Ge) individuals can form anti-Ge after exposure to the Ge antigen through transfusion or pregnancy. Anti-Ge2 is more commonly found than anti-Ge3. There have been only rare case reports of HDFN due to anti-Ge3. Aim: To present a case in which anti-Ge3 was proven first time in the third trimester of second pregnancy. The first child was born healthy. Methods: All serologic methods which were used for antibody identification (saline, enzyme and LISS IAT in tube and Bio-Vue Ortho and Bio-Rad micro cards) positive results with all test red blood cells were given. IAT antibody identification in polyspecific micro cards positive reactions (2+ to 3+), but LISS-IAT tube test weak positive reactions (w to 1+) were given. IBGRL Bristol confirmed the presence of anti-Ge3. After birth female baby had weakly positive DAT and IAT in Bio-Vue micro card only (1+ score 3–4). An elute prepared from cord RBCs was nonreactive. Results: After birth neonate had normal initial haemoglobin result and total bilirubin values. Bilirubin was increased 2 day after birth. The physicians started with phototherapy during 4 days and discharged baby from hospital on day 7. Because anti-Ge3 could cause late anaemia several weeks after delivery, the baby was followed as an outpatient 5 weeks. Considering that baby had been in good condition, there was no need for transfusion therapy. Conclusion: According to the literature data, anti-Ge3 could be dangerous antibody in pregnancy. Because there are no correlation between strength of positive DAT and clinical outcome, we consider that neonates require close follow-up from birth till 1 month after birth.

HAEMOLYTIC DISEASE OF FETUS AND NEWBORN ANTI-GE3

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