[Severe fetomaternal anti-Duffy allo-immunization].

The authors report a case of severe post-transfusion anti-Duffy (Fya) allo-immunization which required a treatment of four intrauterine exchange transfusions. The child was born at 32 weeks of amenorrhoea and he benefited from an exchange perfusion at birth. The outcome was fully satisfactory. On the basis of this case, the authors present a review of immuno-haematology concerning the Duffy system. This system holds fourth rank, after the ABO, rhesus and Kell systems, on the clinical importance scale of group systems. It concerns two alleles, Fya and Fyb, located on the first chromosome. The anti-Duffy antibodies are IgG immune antibodies; they may be responsible for haemolytic accidents, sometimes lethal, during transfusions, and they are an occasional cause of haemolytic disease of the newborn. A review of the literature yielded only 25 cases of haemolytic disease of the newborn, thereby showing that this allo-immunization is very rare, and it demonstrated its potential danger. Finally, the authors present the therapeutic methods used to treat the haemolytic disease of the newborn caused by anti-Duffy antibodies. Plasmapheresis and intrauterine exchange perfusion have dramatically improved the prognosis of this disease.