Hemolytic Disease of the Newborn Due to Anti-A

By HAL CRAWFORD, B.SC., MARIE CUTBUSH, B.Sc., AND P. L. M0LLI50N, M.D., M.R.C.P. T HE DIAGNOSIS of hemolytic disease of the newborn is made by demonstrating incompatibility between the mother’s serum and the infant’s red cells, associated w-ith signs of red cell destruction in the infant . When the disease is due to anti-Rh itis not uncommoui to find evidence of serologic incompatibility, including a positive direct antiglobulin test in the infant-, without evidence of a hemolytic process, but signs of a hemolytic process are never found in the absence of a positive directantiglobulin test. In hemolytic disease of the newborn due to anti-A, the diagnosis is made far more difficult by tw’o facts: first, that the direct antiglobulin test may be negative; and second, that the demonstratiout that the mother’s serum contains anti-A and the infant belongs to group A has by itself little significance. The present paper summarizes observations on 11 infants in whom the diagnosis of hemolytic disease of the newborn due to anti-A was made. It is demonstrated that there are two signs which are of value in establishing the diagnosis: the presence of a hemolysin in the mother’s serum and of a raised osmotic fragility of the infant’s red cells.