Severe haemolytic disease of a newborn with variant D mimicking blocked-D phenomenon

What is it about?

Anti-D is still the most common antibodies causing severe Hemolytic Disease of Fetus and Newborn. In a mother with very high titer of anti D, antibodies can coat and block the D antigens on the red blood cells of the newborn. This blocking phenomenon prevents agglutination of the D-positive red cells with the IgM anti-D typing reagent, giving false negative results. Here, we report the case of a newborn with variant D phenotype and severe HDFN, which mimicked the blocked D phenomenon, which, at the first instance confused both the treating clinicians and transfusion service personnel.

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