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A Pair of Male Fraternal Twins with Contrasting Manifestations of Rh Hemolytic Disease

Published online by Cambridge University Press:  01 August 2014

Alexander S. Wiener
Affiliation:
From the Division of Immunohematology and the Department of Pediatrics, theJewish Hospital of Brooklyn, and the Serological Laboratory of the Office of the Chief Medical Examiner of New York City
Irving B. Wexler
Affiliation:
From the Division of Immunohematology and the Department of Pediatrics, theJewish Hospital of Brooklyn, and the Serological Laboratory of the Office of the Chief Medical Examiner of New York City
Edward J. Schutta
Affiliation:
From the Division of Immunohematology and the Department of Pediatrics, theJewish Hospital of Brooklyn, and the Serological Laboratory of the Office of the Chief Medical Examiner of New York City

Summary

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A pair of male, Negro, fraternal twins are described, both of whom were affected with Rh hemolytic disease. In one twin, the manifestations were typical; jaundice appeared early, exchange transfusion was carried out, and this was followed by prompt and complete recovery. In the second twin, who was treated expectantly, jaundice appeared later and followed the protracted course of the so-called «inspissated bile» syndrome, i. e., the stools were acholic, there was bile in the urine, and most of the serum bilirubin was of the direct reacting type. Of interest was the finding that the occurrence of the syndrome was presaged by the presence of excessive amounts of direct reacting bilirubin in the cord serum. This twin also recovered completely, but convalescence was more prolonged.

The observations on these twins provide further evidence that the constitution of the baby, in addition to the maternal Rh antibody titer determine the nature and severity of the manifestations in an erythroblastotic baby.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1962

References

1. Levine, P., Burnham, L., Katzin, E. M., and Vogel, P.: The rôle of isoimmunization in the pathogenesis erythrobastosis fetalis. Amer. J. Obst. and Gynec., 42: 925, 1941.CrossRefGoogle Scholar
2. Sacks, M. S., Kuhns, W. J., and Jahn, E. F.: Studies in Rh immunization in pregnancy. Amer. J. Obst. and Gynec., 54: 400, 1947.CrossRefGoogle Scholar
3. Wiener, A. S., Nappi, R., and Gordon, E. B.: Studies in Rh sensization. Importance of the titer of Rh antibodies in the sensitized pregnant Rh-negative woman for prognosis. Amer. J. Obst. and Gynec., 63: 6, 1952.CrossRefGoogle ScholarPubMed
4. Kariher, D. H., and Miller, D. I.: Evidence of maternal Rh sensitization without evidence of hemolytic disease in the newborn. Amer. J. Med. Sci., 212: 327, 1946.CrossRefGoogle ScholarPubMed
5. Wiener, A. S., and Brancato, G. J.: Problems in the management of erythroblastosis fetalis. II. Additional examples exhibiting unusual clinical and serologic findings. J. Lab. and Clin. Med., 46: 757, 1955.Google ScholarPubMed
6. Wiener, A. S.: Rh-Hr Blood Types. Applications in Clinical and Legal Medicine and Anthropology. 1954. Grune and Stratton, New York.Google Scholar
7. Wiener, A. S.: Advances in Blood Grouping. 1961. Grune and Stratton, New York.Google Scholar
Wiener, A. S.: Moderne Blutgruppen-Mythologie. Geburts. und Frauenheilk., 21: 726736 (08) 1961; Modern Blood Group Mythology. J. For. Med. (S. Afr.), 7: 166-176 (Oct.-Dec.) 1960.Google Scholar
Wiener, A. S. Advances in Blood Grouping. Grune & Stratton, New York, 1961.CrossRefGoogle Scholar
Wiener, A. S. Principles of blood group serology and nomenclature. Transfusion, 1: 308320 (09-Oct.) 1961.CrossRefGoogle ScholarPubMed
Biological Handbooks, Blood and Other Body Fluids. Analysis and Compilation by Philip L. Altman, Federation of American Societies for Experimental Biology, Washington, DC.Google Scholar
Dorland's Illustrated Medical Dictionary. 23rd Edition, W. B. Saunders, London, 1957.Google Scholar
Stedman's Medical Dictionary. 20th Edition, 1680 pages; Williams and Wilkins Co., Baltimore, Md. 1961.Google Scholar