• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.21-24
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• 2013

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-$Di^a$Dia antibody rarely occurs. The anti-$Di^a$ antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the $Di^a$ antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-$Di^a$ antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-$Di^a$ antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-$Di^a$ antibody identification test is recommended due to the suspicion of an anti-$Di^a$ antigen, followed by early administration of intravenous immunoglobulin.

• Neonatal Medicine
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• 제15권2호
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• pp.190-195
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• 2008

저자들은 항-E항체에 의한 신생아 동종 면역성 용혈성 질환 환아에서 생후 8일째 담낭내 오니가 있고 4개월, 9개월, 11개월 및 50개월 후 추적 초음파에서 담석을 보인 1례를 경험하였기에 보고하는 바이다

• Clinical and Experimental Pediatrics
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• 제46권7호
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• pp.718-721
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• 2003

저자들은 신생아 용혈성 질환을 일으킨 아기를 분만한 산모와 신생아에서 $anti-Jk^b$를 동정하여 진단하였으며, 이에 대해 그 임상경과를 문헌고찰과 함께 보고하는 바이다. 따라서, 생후 24시간이내 신생아 황달이 있는 경우 군소 혈액형 부적합증에 의한 신생아 용혈성 질환을 감별하여야 하며, 불규칙항체 선별 검사나 불규칙항체 동정 검사를 통하여 항체를 규명하고, 광선요법이나 교환수혈 등을 실시하여 핵황달 예방에 주의함과 동시에 지연성 빈혈이 없는지 지속적인 관찰이 필요할 것으로 사료된다.

• Neonatal Medicine
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• 제17권2호
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• pp.266-269
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• 2010

Gilbert 증후군(Gilbert's syndrome)은 빌리루빈의 체외배설을 위해 포합시키는 기능을 가진 효소인 uridine diphosphate glucuronosyltransferase (UGT)의 활성도 감소에 의해 야기되며 만성, 비용혈성, 비포합 고빌리루빈혈증을 유발한다. 대부분 경증의 증상을 보이며 인구의 3-10%에서 나타나는 것으로 알려져 있다. 치료로 페노바비탈(phenobarbital)을 투여할 수 있으며 이 페노바비탈은 UGT 효소활성도를 증가시켜 혈중 빌리루빈 농도를 떨어뜨린다. 본 증례에서는 일반적인 경우와 달리 심한 신생아 황달이 동반된 Gilbert 증후군을 기술하였다. 환아는 생후 2-3일경부터 황달 소견을 보였으며 생후 5일경 혈중 총빌리루빈 수치가 34 mg/dL로 높게 상승되어 있어 집중적인 광선치료의 시행과 함께 경구 페노바비탈을 투여 받았다. 검사실 소견에서 정상 혈색소, 망상적혈구 수치 보였으며 direct Coombs' test 에서도 정상 소견 보여 용혈성 고빌리루빈혈증은 제외하였으며 이후 시행한 유전자 검사에서 UGT1A1 유전자의 -3279T>G, 211G>A 변이가 발견되어 Gilbert 증후군으로 진단되었다. 광선치료와 경구 페노바비탈 투여로 혈중 총 빌리루빈 농도의 지속적 감소를 보여 퇴원하였으며 이후 외래검사상 총 빌리루빈 수치는 안정적이었다. 저자들은 심한 신생아 황달을 보인 Gilbert 증후군의 예를 보고하는 바이다.

• 대한미생물학회지
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• 제8권1호
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• pp.27-32
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• 1973

Listeria monocytogenes human infection is a relatively rare disease which usually is meningitis in newborn babies. The organism was isolated from blood cultures of a 52 year old female patient with meningitis. It was considered that the underlying disease, i.e. S.L.E., and the steroid therapy which the patient had been receiving played some role for the Listeria infection. The isolate was showing characteristics of L. monocytogenes, i.e. diphtheroid like morphology, motility with four peritrichous flagella, hemolytic small colonies on blood agar, growth in the presence of 7.5% salt and at 4 C, and inducing monocytosis in an experimentally infected rabbit. Serologically the organism was identified as L. monocytogenes 4b. The isolate was showing susceptibility to many antibiotics tested including ampicillin, penicillin and tetracycline which were the recommended drugs of choice for the treatment of Listeriosis. It is the general opinion that Listeriosis is not so rare as literatures are showing. It is considered that some of the isolate of the organism from clinical specimens are mistakenly discarded due to the fact that the organism shows diphtheroid like morphology and that not many laboratories are able to recognize the organism. Literatures are seen which emphasize more careful examination of gram positive bacilli with diphtheroid like morphology especially when they are isolated from blood or from spinal fluid of patient.