A newborn is left at a hospital emergency department. The baby appears lethargic and slightly jaundiced. Laboratory work on the baby shows a positive DAT with polyspecific AHG and anti-IgG. The hemoglobin is 7.3 gm/dl, and the peripheral blood smear shows marked polychromasia, macrocytosis, and an increased number of nucleated RBCs. The bilirubin is 4.4 mg/dl. What do you suspect is the underlying cause of these results?

Question

Quizplus · Accepted Answer

The positive DAT with anti-IgG and polyspecific AHG and the presence of anemia, polychromasia, macrocytosis, and increased nucleated RBCs indicate hemolytic disease of the fetus and newborn (HDFN), most likely due to Rh incompatibility between the mother and the baby. The slightly jaundiced appearance, elevated bilirubin, and lethargy further support this diagnosis. ABO HDFN and normal postnatal findings are less likely causes based on the lab results, and autoantibody from the mother would not cause a positive DAT with anti-IgG and polyspecific AHG.

A Newborn Is Left at a Hospital Emergency Department