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Anti-Emm in a pregnant patient--case report
M M Wagner1, F M van Dunné, I Kuipers
1Department of Gynaecology, Medical Center Haaglanden, The Hague, the Netherlands; Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands.
Vox Sanguinis
|October 30, 2013
Summary
A rare anti-Emm antibody was detected in a pregnant patient, posing challenges for monitoring and transfusion. This is the first reported case of anti-Emm in pregnancy.
Area of Science:
- Immunology
- Obstetrics
- Transfusion Medicine
Background:
- Antibody screening in pregnancy is crucial for detecting alloantibodies that can cause hemolytic disease of the fetus and newborn (HDFN).
- High-frequency antigens (HFAs) present unique challenges in antibody identification and management due to their prevalence in the population.
Observation:
- A 23-year-old primigravida presented at 15 weeks gestation with a positive antibody screen.
- An antibody to an unknown HFA, reactive with the father's red blood cells, was detected.
- This necessitated careful monitoring for HDFN and planning for compatible blood for potential perinatal transfusion.
Findings:
- The antibody was identified as anti-Emm two months postpartum.
- This case represents the first documented instance of anti-Emm in a pregnant patient.
Implications:
- The identification of anti-Emm in pregnancy highlights the importance of comprehensive antibody screening and identification, even for antibodies to unknown HFAs.
- Management strategies for HDFN caused by anti-Emm need to be established.
- This case underscores the need for vigilance in transfusion practices during pregnancy, particularly when dealing with antibodies to HFAs.
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