I
N SUMMARY
I
SO
-I
MMUNIZATION
I
SOIMMUNIZATION
H
istory Of Rh Isoimmunization
•T
he Rh story is one of multiple foci of independent investigations
–O
ccurring at differen
t
sites
–D
ifferent times
•H
igh level of competition that can develop
–L
aboratory scientists
–C
linical scientists
–P
harmaceutical industry
O
rtho Pharmace utical Company
•
T
rade name RhoGAM, three decades ago
•
R
h Isoimmunization affected approximately 1 percen t of
t
he pregnancies in the U.S. at the
b
eginning of this century
C
linical findings
•
H
emolytic anemia
•
E
dema of the fetal tissues known as
h
ydrops
(
eryhtroblastosis)
f
etalis
•
A
utopsy evidence of proliferation of red blood cells in multiple sites
•
L
arge of number o
f
immature red cells
•
1
930s
-
recognized as one clinical entity were
•
H
ydrops fetalis
•
I
cterus gravis neonatorum
•
C
ongenital anemia
•
E
rythroblastosis fetalis
•
W
orld War II lead to discovery of antigenic blood fac tors, which might result in immunization
a
nd caus
e
transfusion reac tions.
•
Major contributors
•
A
lexander Wiener
•
P
hilip Levine,
•
K
arl Landsteiner
C
auses of fetal hydrops
L
ymphatic Abnormalities
•
L
ymphangiectasia
•
C
ystic hygroma
•
T
urner's syndrome (XO)
•
N
oonan's syndrome
•
M
ultiple ptergium syndrome
•
P
ulmona
r
y Malformations
•
L
ymphangiectasia
•
C
hylothorax
•
C
ystic adenomatoid malformation
•
H
ypoplasia
•
O
ther
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