Rhesus (Rh) alloimmunization is potentially devastating for reproductive health. Rarely, RhD mismatched blood may be transfused accidentally, increasing the risks of RhD sensitization. Prevention of Rh sensitization is important especially in women of reproductive age group. Treatment with intravenous RhIg is potentially safe and also the effective means of preventing Rh alloimmunization in cases of Rh-mismatched blood transfusion. We report a case that illustrates the significantly high RhD antibody titers following treatment with intravenous Rh immunoglobulin for prevention of alloimmunization. An 18yo Rh-negative G0 had mistakenly received four units of Rh-positive blood. To avoid future pregnancy related complications, she received monotherapy with 13,200 μg total of intravenous Rh immunoglobulin (RhIg). The treatment was well tolerated; however the RhD antibody titers reached a peak of 1:512. The high levels of RhD antibody titers can have grave implications if the patient is pregnant.
Alloimmunization, mismatched blood transfusion, Rh immunoglobulin, anti Rh- D titers, exchange transfusion
The authors report no conflict of interest.
Copyright © 2014 Vani C. Movva and Asha Rijhsinghani
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Movva VC, Rijhsinghani A. Large doses of intravenous Rh (D) immunoglobulin lead to sustained elevations in Rh antibody titers. Proc Obstet Gynecol. 2014 Oct 30;4(2):Article 6 [6 p.]. https://doi.org/10.17077/2154-4751.1250. Free full text article.