antiDantikroppar

Anti-D antibodies (anti-D-antikroppar) are antibodies directed against the D antigen of the Rh blood group system. They are typically of the IgG class and are formed after exposure to D-positive red blood cells, most often through pregnancy or blood transfusion in individuals who are RhD-negative. These antibodies can cross the placenta and reach fetal red blood cells.

Clinically, anti-D antibodies are most significant in two settings. In pregnancy, maternal anti-D antibodies can cause hemolytic disease of the fetus and newborn (HDFN) when the fetus carries the D antigen. The severity varies and can lead to anemia, jaundice, and other complications in the fetus or newborn. In transfusion medicine, anti-D can cause hemolytic transfusion reactions if an RhD-negative recipient receives D-positive blood. Proper antigen typing and the use of D-negative blood products mitigate this risk.

Diagnosis involves serologic testing. An antibody screen (indirect antiglobulin test) detects alloantibodies in the patient's serum, while a direct antiglobulin test (DAT) on newborns can help diagnose HDFN. Antibody titers may be monitored during pregnancy to assess risk, though management also depends on overall clinical context. Prophylaxis with Rh immunoglobulin (RhIG) is given to RhD-negative pregnant women during pregnancy and after delivery to prevent sensitization and formation of anti-D antibodies. In transfusion settings, compatibility testing and the selection of D-negative blood products for RhD-negative recipients are standard practices. Treatment for affected neonates can include phototherapy or exchange transfusion, depending on the severity of HDFN.