Anti-Kell (KEL1)

Blood Group: Kell

Common: 91% of caucasians, 98% of blacks are kk and could develop anti-Kell [6]

Causes HDN: Yes
Critical Titer: 1:8*
Information: 
Anti-Kell suppresses fetal production of red blood cells [1]. Kell antigens are found on the surface of the cells that will become RBCs, so anti-K will destroy the progenitor cells before they even turn into red blood cells. Because the RBC precursors (the progenitor cells) do not have hemoglobin, less bilirubin is released. Less bilirubin being released means that jaundice is less common in Kell infants, but the underlying anemia may still be severe. [3]


*Anti-Kell can cause severe anemia regardless of titer. [4] 

Anti-Kell suppresses the bone marrow in addition to destroying the blood cells [5]. This makes it harder for baby to recover from anemia. In addition to having RBC broken down, the body cannot make more. 


Articles:
1 - https://www.ncbi.nlm.nih.gov/books/NBK2270/
2 - http://www.jbc.org/content/276/13/10247.full
3 - http://www.nejm.org/doi/full/10.1056/NEJM199803193381204
4 - https://www.ncbi.nlm.nih.gov/pubmed/17470588
5 -  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562135/
6 -  http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/clinical/obstetrics-gynecology-womens-health/kell-sensitization-can-cause-fe?page=full
7 -  https://www.ncbi.nlm.nih.gov/pubmed/2081378