Comparative Aspects of Haemolytic Disease of the Newborn by M.D. G. Fulton Roberts

By M.D. G. Fulton Roberts

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G. D, d, D . Race, Sanger and Selwyn (1951) described a sample of blood in which no evidence could be found of any form of the C or Ε antigens which are normally inherited together with some form of the D antigen. The authors had some grounds for speculating whether some of the genetic material that should have formed the C and Ε antigens (or their allelomorphs) might not have become incorporated in the D antigen so that more D substance than usual might be present on the red cells. However that may be, they showed that this cell Serological Considerations 63 sample, whose genotype they called —D—/—D—, was in fact more reactive with anti-D sera than the usual run of D-positive cells.

This may occur in cells which contain no pigment, just as pigmented cells may show no morphological change (Corner, 1955). Corner also observed that the vascularity in the affected areas may be increased. After the first week of life, the changes become more marked. There is oedema of the brain and sometimes a slight degree of glial reaction; many more ganglion cells are seen to be dead or dying. The final picture in cases that survive is akin to a widespread demyelinating disease relating presumably to those areas that would have been pigmented in the acute stage.

First, it has been thought that each red cell in a single individual of a species is similarly endowed with blood group antigens. So far no evidence has caused this view to be seriously doubted, if one excepts the circumstances, rare in man but not unusual in cattle, of an exchange of haemopoietic tissues between binovular twins in utero. g. that 60 Serological Considerations 61 all rhesus positive people are equally rhesus positive. This, however, is probably not true. A simple example is the difference between a sample of homozygous cells (XX) and a heterozygous sample (XY), the former giving the higher titre against the specific antibody (anti-X).

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