Salamat N, Bhatti F A, Hussain A, Ziaullah.
Anti-Rh17 (Anti-Hr0): a rare diagnostic and management problem.
J Pak Med Assoc Jan ;54(4):215-8.

A 35 years old lady, (g4, term 2, abortion 0, live birth 1) diagnosed case of moderately severe mitral valve stenosis was admitted with amenorrhoea of 7 months duration, shortness of breath NYHA III/IV and palpitations for 5 months. Her first pregnancy ended in intrapartum death in 1998 at full term. Next year a full term healthy boy was delivered by Caesarean-section and patient was transfused one unit of whole blood in postpartum period. The child did not have a history of neonatal jaundice or anemia. In 2001 her next pregnancy ended with intrauterine death at 34th week of gestation and dead hydropic fetus was delivered by Caesarean-section. Fourth pregnancy started in Oct 2002 and she became progressively dyspnoeic, had palpitations and was hospitalized. Her physical examination besides mitral stenosis, revealed Abdominal fundal height of 38 weeks while gestational age by dates was 34 weeks. Her haemoglobin level was 4.3 g/dl, with microcytosis and hypochromia. Echocardiography showed moderately severe mitral stenosis. Rest all of the investigations were normal. Ultrasound of abdomen revealed single alive foetus with ascites and pleural effusion, suggesting hydrops foetalis, whereas placenta was large and fundal and she had developed polyhydramnios. She was treated accordingly. Clotted blood sample of the patient was sent for grouping and cross matching. Interpretation of serological results was that patient is having IgG type, alloantibody, directed against some high frequency (public) red cell antigen. To determine the specificity of antibody and to find compatible blood, rare red cells panels and antisera were needed which were not available with us therefore patient`s blood samples were sent to International Blood Group Reference Laboratories, Bristol, UK. These results revealed the rare alloantibody in proposita was antiRh17, which was further confirmed by phenotyping patient`s red cells at our center. There were no C/c and E/e antigens on her cells.

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