{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:52:02Z","timestamp":1790628722340,"version":"4.1.0"},"reference-count":26,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0347_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hemolytic disease of the fetus and newborn (HDFN) is a potentially life-threatening condition, caused by maternal alloimmune antibodies targeting fetal red blood cells. This report aims to present a case of severe early-onset anti-K-mediated HDFN, managed successfully with intravenous immunoglobulin (IVIG), therapeutic plasma exchange (TPE) and intrauterine transfusion (IUT), and to discuss comparable alternative approaches reported in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0347_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We treated a 32-year old woman in her third pregnancy with a high titer of anti-K alloantibodies (1:2048), detected in the first trimester. Weekly IVIG therapy of 1\u202fg\/kg was initiated at 15\u00a0weeks of gestation, followed by four TPEs and two IUTs. Due to suspected fetal anemia at 33\u00a0weeks of gestation, we opted for delivery. The newborn required phototherapy and erythropoietin treatment, with normal development at age\u00a0two.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0347_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>To contextualize our approach, we reviewed published cases of anti-K-mediated HDFN and compiled a comparative table of treatment strategies and outcomes. Analysis showed that treatment protocols varied in IVIG dosing, TPE use, and timing, reflecting the absence of standardized approaches. These strategies were associated with delayed IUT and improved neonatal outcomes following prior fetal losses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0347_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our case, along with the review of published cases, supports the use of IVIG, with or without TPE, in managing anti-K alloimmunized pregnancies. The variability in treatment approaches underscores the need for individualized care based on maternal antibody titers, fetal antigen status, and disease progression, while emphasizing the importance of standardized protocols and prospective studies to guide optimal management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0347","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T11:05:05Z","timestamp":1761908705000},"page":"100-107","source":"Crossref","is-referenced-by-count":2,"title":["Successful management of severe hemolytic disease of the fetus and newborn (HDFN) due to anti-Kell"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5409-3863","authenticated-orcid":false,"given":"Erika","family":"Hrastar","sequence":"first","affiliation":[{"name":"Department for Diagnostic Services , 86684 Blood Transfusion Centre of Slovenia , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Bricl","sequence":"additional","affiliation":[{"name":"Department for Diagnostic Services , 86684 Blood Transfusion Centre of Slovenia , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Premru-Sr\u0161en","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology, Department of Perinatology , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Guben\u0161ek","sequence":"additional","affiliation":[{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"},{"name":"Department of Nephrology , University Medical Centre Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilijana","family":"Kornhauser Cerar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"},{"name":"Neonatal Intensive Care Unit, Division of Gynaecology and Obstetrics, Department of Perinatology , University Medical Centre Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polona","family":"Pe\u010dlin","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology, Department of Perinatology , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"2026053006093728152_j_jpm-2025-0347_ref_001","doi-asserted-by":"crossref","unstructured":"Caine, ME, Mueller-Heubach, E. 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