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Correspondence
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Volume 338:1699-1700 June 4, 1998 Number 23
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Fetal Sex and Hemolytic Disease from Maternal Red-Cell Alloimmunization

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 by Kawai, A.
To the Editor: Fetal anemia secondary to maternal Rh alloimmunization is a major cause of intrauterine and postnatal morbidity and mortality. The relations between fetal sex and the antenatal course and outcome of Rh alloimmunization have been unclear.

In mice, male fetal cells in the maternal circulation may trigger a strong maternal rejection response.1 Transplantation studies in humans suggest that male recipients tolerate female tissue well, whereas female recipients tend to reject transplants from male donors.2 The male-specific H-Y antigen may induce a T-cell reaction in the female immune system.3 We hypothesized that male fetuses are more severely affected by . . . [Full Text of this Article]

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