Rhesus Isoimmunization: Late-onset Hemolytic Disease of the Newborn Without Jaundice

Abstract

Rhesus (Rh) isoimmunization commonly presents with anemia and jaundice of varying intensity in the early postnatal period and is usually treated with phototherapy and exchange transfusion. Rarely, babies with mild or no symptoms at birth may present later with severe hemolytic anemia. This report describes a newborn infant with no postnatal jaundice who presented during the second week of life with severe anemia. These findings indicate the importance of regular follow-up and close monitoring of Rh-isoimmunized infants during the first two months of life for delayed onset anemia.

Keywords: anemia; blood transfusion; direct coombs test; hdn; jaundice; newborn; phototherapy; rh isoimmunization.