Am J Perinatol 1999; Volume 16(Number 8): 0391-0398
DOI: 10.1055/s-1999-6820
Copyright © 1999 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212)760-0888 x132

ABO Hemolytic Disease of the Newborn: A Unique Constellation of Findings in Siblings and Review of Protective Mechanisms in the Fetal-Maternal System

Peter Waldron, Pedro de Alarcon
  • Department of Pediatrics, University of Virginia, School of Medicine, Children's Medical Center, Charlottesville, Virginia
Further Information

Publication History

Publication Date:
31 December 1999 (online)


-Two siblings born 6 years apart presented with similar findings of hepatosplenomegaly, dermal hematopoiesis, hemoglobinuria, and increased platelet consumption, but only moderate anemia and normal serum bilirubin. ABO incompatibility was identified, and other causes were excluded. A review of the current understanding of mechanisms that promote and prevent antibody-mediated hemolysis in the fetus is reviewed. Due to the low ratio of observed to expected significant clinical events among ABO incompatible mother-infant pairs, and the multiplicity of mechanisms that diminish hemolysis, we speculate that severe ABO hemolytic disease of the newborn occurs when there is a specific failure in one of these preventive mechanisms.