By Andrew Hadley, Peter Soothill
The powerful prevention, analysis, and administration of alloimmune cytopenias has develop into a group attempt concerning hematologists, obstetricians, pediatricians, immunologists, laboratory technicians, midwives, and study scientists. This booklet has been written by means of specialists of their respective fields to assemble the problems of pathogenesis, epidemiology, prevention, prognosis, and medical administration. This accomplished yet obtainable account is greatly cross-referenced to stress the hyperlinks among pathogenesis and medical sequels, among epidemiology and the reason for screening courses, and among prognosis and healing intervention.
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Extra resources for Alloimmune Disorders of Pregnancy: Anaemia, Thrombocytopenia and Neutropenia in the Fetus and Newborn
31 Bux J (1999). Nomenclature of granulocyte alloantigens. Transfusion, 39, 662–3. 32 Madyastha PR, Glassman AB & Levine DH (1984). Incidence of neutrophil antigens on human cord neutrophils. American Journal of Reproductive Immunology, 6, 124–7. 33 Morell A, Skvaril F, van Loghem E & Kleemola M (1971). Human IgG subclasses in maternal and fetal serum. Vox Sanguinis, 21, 481–92. 34 Story CM, Mikulska JE & Simister NE (1994). A major histocompatibility complex class Ilike Fc receptor cloned from human placenta: possible role in transfer of immunoglobulin G from mother to fetus.
Multifarious red cell antigens will be mentioned in this chapter and it is not possible to refer to the original publications describing all of them. 2 Blood group terminology During the course of the 20th century, several hundred red cell antigens have been identiﬁed. The extended time period over which these antigens were discovered has 21 22 G Daniels led to a variety of diﬀerent terminology styles being introduced. In some cases, single capital letters were used; for example, in the ABO system, the letters A and B represent the two main antigens (and the phenotypes in which only those antigens are present) and O is used for the phenotype resulting from homozygosity of a third allele (O), which produces neither A nor B.
4 Antibody specificity IgG antibodies to most red cell antigens have been reported to cause HDFN. The relationship between antibody speciﬁcity and clinical signiﬁcance is reviewed in Chapter 2. However, it is possible to establish criteria which govern the potential of blood group antibodies to cause haemolysis in utero and these will be discussed brieﬂy here. First, antibodies with the potential to cause haemolysis in utero recognize antigens which are restricted to the erythroid lineage; antibodies to antigens with a wider tissue distribution are absorbed by other fetal tissues and hence fail to localize on fetal red cells.