Relapsing haemolytic anaemia of pregnancy with negative antiglobulin reaction

Four patients are described in whom seven episodes of haemolytic anaemia associated with pregnancy were observed during a follow-up period of 2 to 16 years. Normal haemoglobin levels were found both before and after pregnancy. Despite consistently negative antiglobulin tests, an autoimmune haemolytic mechanism is suggested by the rapid destruction of transfused blood, favourable response to corticosteroids and the development of transient haemolytic anaemia in three of the infants. In view of its unique clinical and laboratory features and relatively mild course, recognition of this condition as a distinct clinical entitity seems to be justified.