Hemolytic Disease of The Newborn (anti-Kell)

Hemolytic Disease Of The Newborn (anti-Kell)

Hemolytic disease of the newborn (anti-Kell1) is the second most common cause of severe hemolytic diseases of newborns (HDN) after Rh disease. Anti-Kell1 is becoming relatively more important as prevention of Rh disease is also becoming more effective.

Hemolytic disease of the newborn (anti-Kell1) is caused by a mismatch between the Kell antigens of the mother and fetus. About 91% of the population are Kell1 negative and about 9% are Kell1 positive. A fraction of a percentage are homozygous for Kell1. Therefore, about 4.5% of babies born to a Kell1 negative mother are Kell1 positive.

The disease results when maternal antibodies to Kell1 are transferred to the fetus across the placental barrier. These antibodies can cause severe anemia by interfering with the early proliferation of red blood cells as well as causing alloimmune hemolysis. Very severe disease can occur as early as 20 weeks gestation. Hydrops fetalis can also occur early. The finding of anti-Kell antibodies in an antenatal screening blood test (indirect Coombs test) is an indication for early referral to a specialist service for assessment, management and treatment.

Read more about Hemolytic Disease Of The Newborn (anti-Kell):  Cause, Prevention, Management, Anti-Kell2, Anti-Kell3 and Anti-Kell4 Antibodies

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