Published Aug 18, 2004
We have a mom who delivered who is A positive but was discovered to ave a jka antibody, or Rautenberg antibody in her blood. Thus, her newborn is being monitored for jaundice etc...Has anyone heard of this or had a patient with it? If so, what can you tell me as to what she can expect, what it means if anything..I did a search and there isn't a lot about it other than ramifications if the dad has the antibody as well or during the pregnacy vs after delivery. Any info people have would be appreciated...I know I can search further, and will as far as the internet goes. Just wondering if people out there have been personally or professionally confronted with this...Thanks.
I know very little about this because often these pregnancies spontaneously abort long before term delivery. These patients are often habitiual miscarriers. It causes erythroblastosis in the fetus. That is all I know. I would worry a bit about the prognosis for this newborn. I am sure there are smarter individuals out there than me who can say MUCH More about this.
Thanks for the reply...This is this patients fourth child and none of them have been compromised in any way..She also has no history of miscarriage...Apparently had one negative and two positive tests. Quite a mystery..Bilis on her breast feeding baby are WNL.....Will keep you posted...
Finally: something I know A LOT about :-)
Anti-Jk(a) is a common and POTENT antibody that we see in the blood bank. It can cause HDN as well as SEVERE Hemolytic transfusion reactions (and DELAYED hemolytic transfusion reactions). More important than the bili levels is the baby's DAT. Was it positive? If it was positive, the blood bank should have resolved it (meaning that was it positive because the baby was type B or AB - this would be an ABO-HDN because if baby is A or O, it is ABO compatible with mom).
The other (AND VERY IMPORTANT) reason that the DAT could be positive is because the baby is positive for the JkA antigen and the mother's antibody is coating the baby's red cells --> thus causing the +DAT, high bilis, etc, etc, etc.
If the baby's DAT is negative, and depening on how sophisticated (sp?) your blood bank department is, they could antigen type the baby's red cells and see if he is + or = for Jk(a). If the baby has a + dat, then they cannot test the baby for the Jka antigen because the test occurs at the same phase (Coombs) where you see the positive DAT. Depending on how "monogamous" the mother and father are, they could type dad for the anitgen (mom has to be = to make the antibody and if dad is negative, you can say that baby is negative....if that is really the father...gets sticky there).
MOST IMPORTANT piece of info: The Anti-Jka antibody will lose it's titer with time. If something happened to mom and 2 years later she was in a car wreck and needed blood, her screen could revert back to negative. Remeber, -Jka's cause SEVERE HTRs and delayed HTRs. SHE NEEDS A MEDICAL ALERT CARD/BAND stating that she has this antibody (and she must receive antigen negative blood from here on out)... if your blood bank is on the ball, they should have all ready alerted her OB/GYN (or better yet given the patient a card).
Hope this helps,
Christine, BSMT, MT(ASCP) (
Thankyou SO much..Bili on the first day went from 4 to 6 but the family went home on the third day so don't know what went on...I will most definitely post this on the unit to indicate the importance and very much appreciate the time you spent explaining it...Thankyou! Mera
you're welcome... glad to explain... anytime
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