Abstract:

A report on the diagnosis and treatment process of a patient with severe neonatal hemolytic disease (HDN) caused by anti-Dib incompatibility was made. The full-term male neonate developed severe yellow staining 4 hours after birth; its local serum total bilirubin level was 239.2 mmol/L; its hemoglobin (Hb) level was 102 g/L; its blood type was A,with Rh (D) (+). The neonate was referred to NICU, Guangzhou Women and Children's Medical Center in September 2019; the results of direct anti-human globulin test, serum free antibody test, and red cell release antibody test were positive; blood group monospecific antibody anti-Dib was detected in the maternal serum sample, so it was diagnosed as HDN caused by anti-Dib. The neonate was treated by immunoglobulin blocking antibody therapy and blue light therapy; during partial transfusion, the Dib- red blood cells was used to correct its anemia; it was cured and discharged 15 days after birth. It was followed up until it was 1 year old, and its growth and development are similar to healthy children of the same age.

Key words:

Neonatal hemolysis,  , Anemia,  , Fetus,  , Anti-Dib, Partial transfusion

摘要：

报道1例由抗-Dib血型不合引起的重度新生儿溶血病（HDN）患者的诊治过程。患儿足月男性，生后4 h出现全身皮肤重度黄染，当地查血清总胆红素239.2 mmol/L，血红蛋白102 g/L，血型A型，Rh（D）（+），2021年9月转诊至广州市妇女儿童医疗中心NICU，直接抗人球蛋白试验、血清游离抗体试验、红细胞释放抗体试验均阳性；母血清标本检出血型单特异性抗体抗-Dib，诊断为由抗-Dib引起的HDN。在蓝光治疗基础上予免疫球蛋白封闭抗体治疗，予部分换血治疗中使用Dib-的红细胞纠正贫血，生后15 d治愈出院。随访至1岁，生长发育与健康同龄儿相仿。

关键词:

新生儿溶血病, 贫血, 胎儿, 抗-Dib, 部分换血术