Anti-RH Rhogam is IgG or another type! - USMLE Forums
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  #1  
Old 06-18-2011
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Immunology Anti-RH Rhogam is IgG or another type!

i was solving Uworld when i faced this question asking :what kind of Ig is the Anti-RH (D) u give to a primigravida present for prenatal check up at 28 weeks gestation
the answer was IgG
but i remember in kaplan immuno-vids that she said before delivery you give anti-RH other than IgG (like igD for example).

i'm really confused with that so anyone can explain it please
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Old 06-18-2011
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they are right...IgG is the answer
"the anti-Rh(D) [RhoGAM] is IgG"...see here

http://www.usmle-forums.com/usmle-st...abys-rbcs.html
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Old 06-18-2011
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so kaplan is wrong
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Old 06-18-2011
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Quote:
Originally Posted by dr.muhamad View Post
so kaplan is wrong
no, kaplan is correct

notes 2010 p. 155 immunology
"human anti-RhD IgG antibody"

Last edited by bebix; 06-18-2011 at 06:10 AM.
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Old 06-18-2011
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yea thx bebix
the wrong thing is in the vids not in the book
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Old 06-18-2011
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Yeah I remember Kaplan lady saying exactly the opposite! I d go with UW

Like in the video she says " It can be something like IgD, but not IgG- because it will cross the placenta". I think she misspoke, because on UW I picked IgD after that and I got it wrong.

Generally IgG does cross the placenta, but I was looking up articles online, and the mechanism of rhogam is different even though it is an IgG( has to do with something like, active state something-forgot it was a long time ago)

Last edited by step1saga; 06-18-2011 at 09:00 AM. Reason: add
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Old 06-18-2011
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Default I think Kaplan is correct

Dears,

I think that Kaplan is correct...
1- Both the mother and the baby will be having Anti-RhD antibodies (the mother in her blood and the baby on his/her RBCs).
2- I think that is totally correct on the video, and I think Goljan said the same thing in his audio lecture about the one that is given to the mother is not IgG because it will definitely cross the placenta.
3- I tired to search RhoGAM site, PDR, Medscape, and epocrates and nothing is mentioned regarding RhoGAM being IgG, they all mention mechanism is unkown and it is classified as pregnancy class C drug (if any one has a good reference for that please let us know).
4- I read in the forum about a study that showed up that is ok to give Anti-RhD antibodies and it will not affect the baby, but couldn't find in the study what type of antibodies were used, they just keep saying Anti-RhD antibodies given to the mother.

Good luck for everyone
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Old 06-18-2011
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http://en.wikipedia.org/wiki/Rho(D)_immune_globulin
anti D is Ig G
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Old 06-18-2011
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Question Still there is a doubt

Quote:
Originally Posted by qurat21 View Post

Dear,
I have seen this wikipedia article before I post, if you notice that the only part that is without a reference is the introductory part which says that anti RhD is IgG
And if you follow the reference that says it is used pre- and postnatally it will take you to the NICE guidlines which only mention anti RhD antibodies cab be given prenatally but doesn't specifically mention the RhoGAM or the type of antibody to be IgG.

So still there is a doubt
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Old 06-18-2011
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D is actually the antigen, which is what rhogam (IgG) acts against.

Its right in kaplan books, but she said IgD on the video which is wrong, because D antigen and IgD are completely different things.

Anything IgG - just like rhogam does cross the placenta, so we think that it will harm the infant when given "during" the pregnancy by crossing placenta. However because of its mechanism against the D antigen, it doesnt do the fetus any harm while given during pregnancy. D is simply the antigen on the Rh group.

However, it is USUALLY found that rhogam is given to rh negative moms , AFTER they give birth to their Rh+ baby---BEFORE concieving the next baby, to avoid the controversy and the doubt. In the UW question, it is admisnistered WHILE the mom is pregnant with the second baby, but in real life situation, she would have recieved rhogam after the birth of the first rh positive infant, so that the IgG in the rhogam will neutralize the antibodies against the rh positive in the blood of the mom (from the first pregnancy). So now that the mom is already neutralized of the anti Rh +(RhD) antibodies, when she concieves the second baby she wont have a problem and she doesnt need to recieve rhogam again. The second baby is completely safe.
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Old 06-18-2011
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here you will find all the Rhogam related published studies : Rhogam (IgG Anti-D (Anti-Rh))

http://www.druglib.com/druginfo/rhogam/abstracts/

among all the papers, please check this two:

"Pharmacokinetics of anti-D IgG in pregnant RhD-negative women."
"Comparative pharmacokinetics of liquid and lyophilized formulations of IV RhIG immune globulin."
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