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A newborn with positive antiglobulin test whose mother took methyldopa in pregnancy
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Özmert M.A. Özdemir, Hacer Ergin, Tülay İnce
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Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, Turkey
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Özdemir ÖMA, Ergin H, İnce T. A newborn with positive
antiglobulin test whose mother took methyldopa in pregnancy. Turk J Pediatr
2008; 50: 592-594.
Methyldopa is known to cause the production of autoantibodies against
red blood cells (RBCs), leading to a positive direct antiglobulin test (DAT)
and hemolytic anemia. In about 20% of patients taking methyldopa, IgG
autoantibodies develop against RBCs. However, most of the patients do not
have hemolysis. A small percentage of such DAT-positive patients, about
2% of those taking methyldopa, develop an autoimmune hemolytic anemia
(AIHA). The fact that the DAT is positive in the newborn with unconjugated
hyperbilirubinemia is considered as an isoimmune hemolytic disease caused
by blood group incompatibility. In this article, a newborn with jaundice and
positive DAT without hemolysis is reported. Her mother had the history of
taking methyldopa in her pregnancy. Thus, when newborns are detected with
positive DAT and jaundice, without blood group incompatibility, mothers
should be questioned regarding drugs used in their pregnancy.
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