Sharing information today to save the lives of tomorrow.
Isoimmunization: An Intro to Antibodies in Pregnancy
Empowering women to be partners in their prenatal care.
Sharing information today to save the lives of tomorrow.
Sharing information today to save the lives of tomorrow.
Anti-Jka (JK1)
Blood Group: Kidd
Common: 23% Caucasians, 8% Blacks, 27% Asians are Jk(a-b+) and at risk for developing anti-Jka [1].
Causes HDN: Yes
Critical Titer: 1:16
Information:
The cases where anti-Jka has caused a problem are few and far between. Of the 4 cases of HDN from anti-Jka mentioned in the article, only 2 required exchange transfusion. After two intrauterine deaths from anti-Jka, the authors treated the infant with immediate exchange transfusion upon birth. [4]
While anti-Jka is usually mild, it can cause severe HDN. In this article, despite exchange transfusion at 3 days old, the infant developed kernicterus. The authors again recommend early exchange transfusions with anti-Jka to avoid Kernicterus. [3]
Kidd antibodies are frequently difficult to detect. This makes them hazardous in transfusion medicine. They are a suspected common cause of delayed hemolytic transfusion reactions. [1]
Kidd antigens are also found on the kidneys [1]. With anti-Jka, titers vary over time or may completely disappear, but they are known to surge at a second exposure to cause delayed hemolytic transfusion reaction (DHTR) [5].
In one article, out of 20 cases of anti-Jka, 16 required monitoring with titers only, while 4 were followed with more diagnostic tests. One pregnancy with the highest titer of 1:32 had an elevated MCA PSV and needed 4 IUTs. A second pregnancy with titers 1:32 had an infant who needed phototherapy to read the HDN. None of the other 18 infants required any therapy for HDN. The article concluded that the 1 severe case of HDN was correctly identified by following titers and MCA scans as used for montioring anti-D. The authors reported that the criteria used for monitoring anti-D affected pregnancies were effective in detecting severe HDN due to anti-Jka. [2]
Articles:
11 - https://www.ncbi.nlm.nih.gov/pubmed/557194