Hemolytic disease of the newborn due to anti-e

In Palestine, antibody screening is done antenatally only for pregnant women who are Rh-D negative. However, we report the first hemolytic disease of the newborn (HDN) due to anti-e in Palestine, illustrating the importance of alloantibodies other than anti-D as a cause of HDN. A pregnant woman had e-antigen negative and her blood group was B positive developed alloantibody against her infant erythrocyte e-antigen that lead to severe jaundice due to fetal erythrocyte destruction by this maternal alloantibody. Postnatal workup for the severe hyperbilirubinemia indicated that the newborn' erythrocytes were sensitized by the maternal anti-e alloantibody. Furthermore, the positive direct Coombs test was reported. This case highlights the importance of antibody screening for all pregnant women irrespective of the D antigen status to detect and manage erythrocyte alloimmunization to any other clinically significant blood group antigens.