Am J Perinatol 1993; 10(5): 362-364
DOI: 10.1055/s-2007-994762
ORIGINAL ARTICLE

© 1993 by Thieme Medical Publishers, Inc.

Severe Hemolytic Disease of the Newborn Caused by Anti-Gonzales Antibody

Ellen Leschek, Stephen A. Pearlman, Ilene Boudreaux, Rita Meek
  • The Medical Center of Delaware, Newark, Delaware
Further Information

Publication History

Publication Date:
04 March 2008 (online)

ABSTRACT

We report on a female infant with severe hemolytic disease of the newborn (HDN) secondary to anti-Gonzales antibody (anti-Goa) necessitating an exchange transfusion within the first day of life. The infant was born to a mother known to be Gonzales-antigen negative and a father who was Gonzales-antigen positive. The mother had an anti-Goa titer of 1:256 at 35 weeks' gestation. The infant was noted to have jaundice shortly after birth, with a bilirubin of 17.8 mg/dl (total) and .05 mg/dl (direct) at 11 hours of life. Coombs' test was positive and cord cells were Gonzales-antigen positive. Eluate on cord cells demonstrated anti-Goa. Despite aggressive phototherapy, the total bilirubin reached 23.3 mg/dl by 24 hours of age and a double-volume exchange transfusion was performed. Following the exchange transfusion, phototherapy was continued for several days. The hemoglobin, which was 19.8 gm/dl at 11 hours of age, remained stable through the hospitalization, and no further transfusions were required. History revealed that two prior pregnancies resulted in Gonzales-antigen positive infants. The first child experienced mild jaundice requiring no therapy, and the second child required phototherapy for prolonged hyperbilirubinemia. Previous reported cases of anti-Goa suggest that this is not a cause of severe HDN. However, in view of the current case, it may be prudent to follow women with anti-Goa prenatally with amniotic fluid bilirubin studies, serial antibody titers, and fetal hemoglobin levels.

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