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The Familial Occurrence of Icterus Gravis, Congenital Anemia of the Newborn, and Erythroblastosis Fetalis: Case Study *

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THE FAMILIAL OCCURRENCE OF ICTERUS GRAVIS, CONGENITAL ANEMIA OF THE NEWBORN, AND ERYTHROBLASTOSIS FETALIS: CASE STUDY* H. C. MILLER In the last few years the close association of hydrops fetalis, congenital anemia of the newborn, icterus gravis neonatorum, and erythroblastosis fetalis has been stressed because of the occurrence of these pathological processes in various combinations in individual children and on some occasions in several of the offspring of one family. The opportunity for observing individually the children of a family thus afflicted has not often presented itself. The object of the present paper is to report the case histories of four siblings delivered in the New Haven Hospital, the first-born of whom had gross congenital anomalies; the second, icterus gravis neonatorum and kernicterus; and the third and fourth, icterus gravis, congenital anemia, and erythroblastosis fetalis. The case studies that have been previously reported in the literature have been adequately summarized in 1932 by Diamond, Blackfan and Baty,1 who added one of their own, and more recently by Hawksley and Lightwood in 1934.2 Pasachoff and Wilson,4 and Netter8 in this country have subsequently published additional familial case studies. The parents of the siblings in the present report were in normal health and were not blood relatives. Both had negative Kahn tests on blood serum. The mother had scarlet fever and diphtheria in childhood; her menstrual history revealed nothing unusual. She was twenty-eight years old when she married and was pregnant thirteen months later. Abstracts of the case histories of the children are as follows, and are given in the order of their births. No other pregnancies are known to have occurred. Case 1. (N. H. H. No. 60,500). The first pregnancy was uneventful except for severe nausea .and vomiting during the early months. After thir- teen hours of normal labor the infant was delivered by cesarean section because * From the Department of Pediatrics, Yale University School

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