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ABO haemolytic disease — RACP Paediatrics MCQ

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HardNeonatologyABO haemolytic diseaseRACP Paediatrics

A term baby is reviewed at 30 hours of age because of jaundice extending to the abdomen. The mother is blood group O positive and the baby is A positive; the baby is feeding but has a weak cry and mild pallor. Bilirubin is above the phototherapy threshold and haemoglobin is low with reticulocytosis. What is the most likely diagnosis?

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Correct answer: A — ABO haemolytic disease of the newborn

The early onset of jaundice, maternal group O with an A group infant, anaemia and reticulocytosis support immune haemolysis from ABO incompatibility. Physiological jaundice is common but does not usually present with anaemia and a bilirubin already above treatment threshold so early. The teaching point is that jaundice within the first 24 to 48 hours should be treated as pathological until haemolysis, sepsis and conjugated hyperbilirubinaemia have been considered.

Reference: RCH Clinical Practice Guidelines: Jaundice in early infancy; Therapeutic Guidelines (eTG)