Two neonates with severe rhesus antagonism inspite of low values in recent tests of antibody dependent cellular cytotoxicity (ADCC)
Janssens, L.P.; Koolen, A.M.; Oei, S.G.; Overbeeke, M.A.
Nederlands Tijdschrift Voor Geneeskunde 143(36): 1823-1826
1999
ISSN/ISBN: 0028-2162 PMID: 10526587 Document Number: 501321
In two female newborn babies severe haemolytic disease of the newborn developed due to anti-RhD antibodies of the mother. In both cases the results of the last antibody-dependent cellular cytotoxicity (ADCC) test had been < 10% (two and three weeks before parturition respectively) making haemolytic disease unlikely. The ADCC test is used to determine the destructive power of the responsible maternal antibodies. It is believed that with a low ADCC value (< 10%), there is no danger of clinically relevant haemolytic disease. The first neonate recovered after exchange transfusion, the second died notwithstanding extensive supportive therapy. A recent low ADCC value makes serious haemolytic disease unlikely, but does not completely exclude it, as the titre of the causative antibodies can rise very quickly.