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[Perinatal hemolytic disease. Part 1: physiopathology]
D Wirthner1, P Hohlfeld, J D Tissot
1Département de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
Summary
Perinatal hemolytic disease occurs when maternal antibodies destroy fetal red blood cells, potentially causing immune hydrops fetalis. This review classifies red blood cell antigens, focusing on the Rhesus system and others like Kell and Duffy.
Area of Science:
- Immunology
- Hematology
- Genetics
Context:
- Perinatal hemolytic disease (HDFN) is a significant cause of fetal morbidity and mortality.
- Maternal antibodies targeting fetal red blood cell (RBC) antigens trigger the condition.
- Over 250 RBC antigens are known, complicating diagnosis and management.
Purpose:
- To provide a comprehensive classification of red blood cell antigens.
- To detail the Rhesus (Rh) blood group system's role in HDFN.
- To review other clinically relevant blood group systems, including ABO, Kell, Kidd, Duffy, MNSs, P, and Lutheran.
Summary:
- The article reviews the pathophysiology of HDFN, emphasizing maternal antibody-mediated RBC destruction.
- It systematically classifies RBC antigens, highlighting the Rhesus system's importance.
- Key antigens beyond Rh, such as Kell, Kidd, Duffy, MNSs, P, and Lutheran, are discussed in the context of HDFN.
Impact:
- Enhances understanding of the immunological basis of HDFN.
- Aids clinicians in diagnosing and managing HDFN by detailing antigen classifications.
- Supports research into novel diagnostic and therapeutic strategies for HDFN.