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Old 05-31-2011
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Unhappy HDN Caused by Mother's O Type Blood?

Goljan RR Patho:

"Blood group O (Universal Donors) individuals are considered universal donors, Anti-A-Igm and anti-B-IgM cannot hemolyze O RBC's"

"ABO HDNB: Mother group O, fetus group A or B"

Now I dont get it, if the mother has group O (universal donor), why would it cause hemolysis in the fetus if type O blood is considered Universal Donor?
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Old 05-31-2011
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The hemolysis is due to naturally ocurring IgG (produced by either transfusion or pregnancy) anti-A (or anti-B), but due to the weaker expression of these antigens on neonatal red cells, clinically significant hemolysis is uncommon.

Book Fetal and Neonatal Pathology 4th Edition 2007
Chapter 8 Perinatal Hematology
Chapter 8 _ Perinatal Hematology.pdf
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Old 05-31-2011
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Originally Posted by bebix View Post
The hemolysis is due to naturally ocurring IgG (produced by either transfusion or pregnancy) anti-A (or anti-B), but due to the weaker expression of these antigens on neonatal red cells, clinically significant hemolysis is uncommon.

Book Fetal and Neonatal Pathology 4th Edition 2007
Chapter 8 Perinatal Hematology
Attachment 1415
Naturally occurring IgG Anti-A / Anti-B in the mother? Why would that be the case since she would have type O, meaning serum antibodies of A/B wouldn't be there.


I think the hemolysis that is present after normal birth is because of switching from HbF to HbA (slowly), so it might cause Jaundice due to lack of gluroynl transferase.
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Old 05-31-2011
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Quote:
Originally Posted by patelMD View Post
Goljan RR Patho:

"Blood group O (Universal Donors) individuals are considered universal donors, Anti-A-Igm and anti-B-IgM cannot hemolyze O RBC's"

"ABO HDNB: Mother group O, fetus group A or B"

Now I dont get it, if the mother has group O (universal donor), why would it cause hemolysis in the fetus if type O blood is considered Universal Donor?
I thought it had to do with serum vs RBCs. If the Mom is type O, her RBCs has no antigens. Therefore you can give her RBCs to anyone and their antibodies won't attack the Mom's O cells because they have nothing to bind to. (I like to think of the RBCs as looking like a blank O with nothing sticking out of it so the little Y shaped antibodies have nothing to bind to). However, the Mom's serum have both Anti-A-IgM and Anti-B-IgM, they will cause lysis if donated to another patient with any combination of A or B blood type. They don't lyse the babies RBC's because IgM doesn't cross the placenta. If however the Mom has IgG antibodies in her serum, they can cross the placenta and cause hemolysis.
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Quote:
Originally Posted by heights View Post
I thought it had to do with serum vs RBCs. If the Mom is type O, her RBCs has no antigens. Therefore you can give her RBCs to anyone and their antibodies won't attack the Mom's O cells because they have nothing to bind to. (I like to think of the RBCs as looking like a blank O with nothing sticking out of it so the little Y shaped antibodies have nothing to bind to). However, the Mom's serum have both Anti-A-IgM and Anti-B-IgM, they will cause lysis if donated to another patient with any combination of A or B blood type. They don't lyse the babies RBC's because IgM doesn't cross the placenta. If however the Mom has IgG antibodies in her serum, they can cross the placenta and cause hemolysis.
But under pathogenesis it states: "Blood group O individuals have anti-A and anti B IgG AB" Doesn't a blood transfusion involve serum & rbc? So therefore, if O type had Anti-A-IgG and Anti-B-IgG, it wouldn't be an universal donor because it'd attack whoever it was given to (except AB).
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Quote:
Originally Posted by patelMD View Post
But under pathogenesis it states: "Blood group O individuals have anti-A and anti B IgG AB" Doesn't a blood transfusion involve serum & rbc? So therefore, if O type had Anti-A-IgG and Anti-B-IgG, it wouldn't be an universal donor because it'd attack whoever it was given to (except AB).
Transfused red blood cells contain minimal serum.
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