PMID- 38238203
OWN - NLM
STAT- MEDLINE
DCOM- 20240408
LR  - 20240426
IS  - 1473-0502 (Print)
IS  - 1473-0502 (Linking)
VI  - 63
IP  - 2
DP  - 2024 Apr
TI  - Successful management of severe Kell alloimmunization in pregnancy with 
      intravenous immune globulin.
PG  - 103868
LID - S1473-0502(23)00297-5 [pii]
LID - 10.1016/j.transci.2023.103868 [doi]
AB  - Hemolytic Disease of the Fetus and Newborn (HDFN) is a condition that affects 1 
      to 2 out of 1000 patients during pregnancy (1). When an alloantibody is present, 
      it is essential to identify its nature in order to organize appropriate 
      follow-up. Kell-mediated HDFN is rare; it occurs in about 5% of Kell 
      alloimmunized pregnant women. It is important to note that in case of anti-Kell 
      immunization, the severity of HDFN is not correlated with maternal antibody 
      titers, and anemia tends to occur earlier and more severely. Therefore, early 
      diagnosing and management of this condition is crucial. In the management of 
      severe fetal anemia due to Kell immunization, available treatments include in 
      utero transfusion (IUT), immunoglobulin therapy. Other alternative treatments 
      exist, such as plasmapheresis. Intravenous immunoglobulin (IVIG), a noninvasive 
      therapeutic approach, acts through multiple mechanisms. IVIG has been evaluated 
      in cases of RhD immunization with high maternal antibody titers and a history of 
      pregnancies involving early hydrops or intrauterine death. Regarding the 
      potential benefits of intravenous IgG therapy, it may delay the need for early 
      IUT, reduce the overall reliance on IUT, and have a positive impact on obstetric 
      outcomes. This case of IV IgG therapy of anti-Kell immunization offers a 
      thought-provoking avenue for future exploration.
CI  - Copyright (c) 2024 Elsevier Ltd. All rights reserved.
FAU - Patris, Marie
AU  - Patris M
AD  - ULB - Erasme Campus, Belgium. Electronic address: mariepatris@hotmail.be.
FAU - Holoye, Anne
AU  - Holoye A
AD  - ULB - Erasme Campus, Belgium.
FAU - Goldman, Deborah
AU  - Goldman D
AD  - CHU Marie-Curie, Belgium.
FAU - De Coninck, Caroline
AU  - De Coninck C
AD  - ULB - Erasme Campus, Belgium.
FAU - Colard, Martin
AU  - Colard M
AD  - ULB - Erasme Campus, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20240105
PL  - England
TA  - Transfus Apher Sci
JT  - Transfusion and apheresis science : official journal of the World Apheresis 
      Association : official journal of the European Society for Haemapheresis
JID - 101095653
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Isoantibodies)
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Humans
MH  - Female
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - *Erythroblastosis, Fetal/therapy/diagnosis
MH  - *Fetal Diseases
MH  - *Anemia, Hemolytic, Autoimmune
MH  - Isoantibodies
MH  - Blood Transfusion, Intrauterine
OTO - NOTNLM
OT  - Anti-Kell immunization
OT  - Hemolytic disease of the fetus and newborn
OT  - Intravenous immunoglobulin
COIS- Declaration of Competing Interest The authors declare no conflict of interest in 
      relation to this work.
EDAT- 2024/01/19 00:42
MHDA- 2024/04/08 06:43
CRDT- 2024/01/18 21:55
PHST- 2023/10/18 00:00 [received]
PHST- 2023/12/24 00:00 [revised]
PHST- 2023/12/28 00:00 [accepted]
PHST- 2024/04/08 06:43 [medline]
PHST- 2024/01/19 00:42 [pubmed]
PHST- 2024/01/18 21:55 [entrez]
AID - S1473-0502(23)00297-5 [pii]
AID - 10.1016/j.transci.2023.103868 [doi]
PST - ppublish
SO  - Transfus Apher Sci. 2024 Apr;63(2):103868. doi: 10.1016/j.transci.2023.103868. 
      Epub 2024 Jan 5.