Abstract：
Hemolytic Disease of the Fetus and Newborn (HDFN) is a condition that affects 1 to 2 out of 1000 patients during pregnancy (1). When an alloantibody is present, it is essential to identify its nature in order to organize appropriate follow-up. Kell-mediated HDFN is rare; it occurs in about 5% of Kell alloimmunized pregnant women. It is important to note that in case of anti-Kell immunization, the severity of HDFN is not correlated with maternal antibody titers, and anemia tends to occur earlier and more severely. Therefore, early diagnosing and management of this condition is crucial. In the management of severe fetal anemia due to Kell immunization, available treatments include in utero transfusion (IUT), immunoglobulin therapy. Other alternative treatments exist, such as plasmapheresis. Intravenous immunoglobulin (IVIG), a noninvasive therapeutic approach, acts through multiple mechanisms. IVIG has been evaluated in cases of RhD immunization with high maternal antibody titers and a history of pregnancies involving early hydrops or intrauterine death. Regarding the potential benefits of intravenous IgG therapy, it may delay the need for early IUT, reduce the overall reliance on IUT, and have a positive impact on obstetric outcomes. This case of IV IgG therapy of anti-Kell immunization offers a thought-provoking avenue for future exploration.
摘要：
胎儿和新生儿溶血病（HDFN）是一种在怀孕期间影响1000名患者中1至2名的疾病（1）。当同种抗体存在时，必须确定其性质，以便组织适当的后续行动。Kell介导的HDFN很少见；它发生在大约5％的Kell同种免疫孕妇中。重要的是要注意，在抗凯尔免疫的情况下，HDFN的严重程度与母体抗体滴度无关，贫血往往发生得更早和更严重。因此,这种情况的早期诊断和治疗至关重要.在由于Kell免疫接种引起的严重胎儿贫血的管理中，可用的治疗方法包括宫内输血（IUT），免疫球蛋白治疗。存在其他替代疗法，例如血浆置换。静脉免疫球蛋白(IVIG),一种非侵入性的治疗方法，通过多种机制。已在具有高母体抗体滴度的RhD免疫和涉及早期水肿或宫内死亡的妊娠史的情况下评估了IVIG。关于静脉注射IgG治疗的潜在益处，它可能会延迟早期IUT的需要，减少对IUT的整体依赖，并对产科结果产生积极影响。这种抗Kell免疫的IVIgG疗法为将来的探索提供了发人深省的途径。
