Anti-D Globulin-Induced Hemolysis in Agammaglobulinemia and Arthritis

Abstract

A major advance in pediatric preventive medicine has been the administration of anti-D globulin to D-negative mothers after delivery to inhibit development of antibodies to the D antigen in the rhesus blood group. This globulin is prepared commercially from pooled plasma of individuals with a high anti-D antibody titer. The indirect Coombs' titer of anti-D of acceptable preparations is usually 1:3,200 or higher.¹ Injections of twice the usual therapeutic amounts of anti-D globulin into a D-positive volunteer have caused only minimal reductions in hemoglobin level and hematocrit value and no ill effects.¹ Our observations in an agammaglobulinemic 4-year-old D-positive girl who received 1,800 µg of anti-D globulin with resulting hemolysis are therefore pertinent.