Neonatal hemolytic disease due to anti-Diego(a) antibody: a case report

BACKGROUND: The Diego(a) antigen commonly occurs in certain Asian and South American Indian populations. In general, hemolysis caused by anti-Diego(a) antigen is not severe, and exchange transfusion is rarely needed. Here, we report a neonate with moderate hemolytic disease caused by anti-Diego(a) antigen in the Baoji area of China. CASE PRESENTATION: A 39-week gestation male newborn of Han nationality was delivered by second cesarean section because of scarred uterus. The newborn’s birth weight was 3700 g with an Apgar score of 9. Four hours after delivery, transcutaneous bilirubin test revealed a level of 17 mg/dl. After 23 hours, the neonate developed anemia and hyperbilirubinemia. Bacterium, virus and other pathogens, as well as tests for arcuate and glucose-6-phosphate dehydrogenase, were all negative. Direct antiglobulin test of the neonate was positive. Diego(a) antigens of the baby and his father were positive, while his mother was negative. The newborn was successfully cured with phototherapy and one-dose intravenous injection of human albumin. CONCLUSIONS: It is important to consider and test for the anti-Diego(a) antibody in cases of hemolytic disease of the newborn of the Han ethnicities of China.