Erythrophagocytosis in hemolytic disease of the newborn.

By MARY B. COOPER, B.A., M.T. (ASCP) I N 1909, Buchan and Comrie” reported the occurrence of erythrophagocytes in the peripheral blood of 2. newborn infants with ‘ ‘congenital anemia and enlargement of the spleen. ‘ ‘ In 193 I , Abt2 described these cells in blood smears of a case of anemia of the newborn. In 1938, Wyatt, Cooper and Groat9 reported 3 cases of the same disease in which the cells were found. At the time of these publications the cause of anemia of the newborn was obscure. It was not until 1941 that anemia of the newborn, icterus gravis neonatorum and hydrops foetalis-now grouped together as hemolytic disease of the newborn -were discovered by Levine and his co-workers6 to be due to the immunization of an Rh negative mother by an Rh positive fetus, and in turn to the injury and consequent hemolysis of the cells of the fetus. Since Levine’s observation there have been two more reports of erythrophagocytosis in hemolytic disease of the newborn. Sennott8 describes 3 cases of ‘acute hemolytic anemia of the newborn. ‘ ‘ In these cases the mothers were Rh negative, the fathers were Rh positive, but the Rh status of the babies and antibody studies of mothers and babies were not mentioned. Barbosa et al.3 report one case of “icterus gravis neonatorum.” In this instance, Rh factor and Rh antibody studies were performed on neither the parents nor the baby. We have been unable to find any published reports of erythrophagocytosis in the blood of newborn infants in the absence of manifestations of a hemolytic process. To the above io cases we wish to add another group of 2.5 infants with hemolytic disease of the newborn showing erythrophagocytes in the peripheral blood.