Late onset neonatal anaemia due to maternal anti-Kpb induced haemolytic disease of the newborn

BackgroundAlloanti-Kpb is a rare, clinically significant antibody against high frequency red cell antigen Kpb of Kell blood group system. We report here a case of Haemolytic disease of newborn (HDN) due to anti-Kpb, which manifested as severe anaemia at the age of 1 month.AimTo diagnose and successfully manage anti-Kpb induced HDN.MethodologyDirect antiglobulin test (DAT), antigen typing, irregular antibody screening and identification were done by polyspecific LISS Coombs Gel card and standard methods.ResultsAt presentation the neonate had severe anemia with reticulocytopenia. Blood group was B, Rh D positive and DAT was 2+. Anti-Kpb was detected in mother’s serum. Due to unavailability of Kpb negative red cells and incompatible blood group of mother (A1B Rh D positive) infant was transfused group B Rh D, Kpb positive PRBCs under steroid cover. He was symptom free at 4 months of age and DAT became negative at 6 months.ConclusionAnti-Kpb is capable of causing severe late HDN. Infants born to irregular antibody positive mothers should be investigated and closely monitored for several weeks after birth for immune HDN even if asymptomatic at birth.