Features of hematopoietic regenerative function in hemolytic disease of the newborn due to Rh-factor incompatibility: a case report

Hemolytic disease of the fetus and newborn (HDFN) is an isoimmune hemolytic anemia that occurs due to maternal-fetal blood group incompatibility based on erythrocyte antigens. In this condition, antigens are present on the fetal erythrocytes, while antibodies against them are produced in the mother‘s body. Depending on the type of immunological conflict, incompatibility may occur in the ABO system, Rh-factor system, or due to rare blood group antigens. Pathological hemolysis results in severe indirect hyperbilirubinemia and progressive anemia. A characteristic feature of HDFN is an increased reticulocyte count, which reflects a compensatory response of the erythroid lineage of the bone marrow to hemolysis. The frequency and severity of late-onset anemia following any type of isoimmune conflict are notably high, reaching up to 83 %. However, the true regenerative capacity of the bone marrow in infants after HDFN remains a matter of debate.

The authors present a case of Rh-factor hemolytic disease of the newborn (severe icteric form) complicated by anemia requiring two blood transfusions during the neonatal period. The study analyzes the patient’s hematopoietic regenerative function through reticulocyte parameters, including absolute reticulocyte count, reticulocyte percentage, reticulocyte index, RET-He, Delta-He, IRF, LFR, MFR, and HFR.

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