Hemolytic disease of the newborn laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

• ABO system
  • ABO hemolytic disease of the newborn can range from mild to severe, but generally it is a mild disease.
    • anti-A antibodies
    • anti-B antibodies

• Rhesus system (the Rh d antigen and Rh d antibodies do not exist)
  • rhesus D hemolytic disease of the newborn (often called Rh disease) is the most common form of severe HDN. The disease varies from mild to severe.
  • rhesus E hemolytic disease of the newborn is a mild condition
  • rhesus c hemolytic disease of the newborn can range from a mild to severe disease - is the third most common form of severe HDN
  • rhesus e hemolytic disease of the newborn - rare
  • rhesus C hemolytic disease of the newborn - rare
  • antibody combinations (ie anti-Rhc and anti-RhE antibodies occurring together) - can be severe

• Kell system
  • anti-Kell hemolytic disease of the newborn
    • anti-K ₁ antibodies - disease ranges from mild to severe - over half of the cases are caused by multiple blood transfusions - is the second most common form of severe HDN
    • anti-K ₂ ,anti-K ₃ and anti-K ₄ antibodies - rare

• Other blood group antibodies (Kidd, Lewis, Duffy, MN, P and others).

Not to be confused with Haemorrhagic disease of the newborn.

The diagnosis of HDN is based on history and laboratory findings:

Blood tests done on the newborn baby

• Biochemistry tests for jaundice
• Peripheral blood morphology shows increased reticulocytes. Erythroblasts (also known as nucleated red blood cells) occur in moderate and severe disease.

• Positive direct Coombs test (might be negative after fetal interuterine blood transfusion)

Blood tests done on the mother

• Positive indirect Coombs test