It suppresses the bone marrow by inhibiting the erythroid progenitor cells.Anti-M also recommends antigen testing to rule out the presence of HDN as the direct coombs can come back negative in a severely affected infant.Kidd antigens are also present on the endothelial cells of the kidneys.One study states that it would be unwise to routinely dismiss anti-E as being of little clinical consequence. It also found that the most severe case of anti-E HDFN occurred with titers 1:2, concluding that titers are not reliable for the diagnosis of the anti-E type. Diagnosis
The diagnosis of HDN is based on history and laboratory findings:Blood tests done on the newborn baby

Biochemistry tests for jaundice including total and direct bilirubin levels. Complete blood count (CBC) which may show a decreased hemoglobin and hematocrit due to red blood cell destruction
Reticulocyte count which will usually be increased as the bone marrow makes new red blood cells to replace the ones that are being destroyed, and a peripheral blood smear to look at cell morphology. In the presence of significant hemolysis the smear will show schistocytes (fragmented red blood cells), reticulocytosis, and in severe cases Erythroblasts (also known as nucleated red blood cells). Positive direct Coombs test (might be negative after fetal interuterine blood transfusion)Blood tests done on the mother

Positive indirect Coombs testBlood tests done on the father (rarely needed)

Erythrocyte antigen status

Prevention
In cases of Rho(D) incompatibility, Rho(D) immunoglobulin is given to prevent sensitization. However, there is no comparable immunotherapy available for other blood group incompatibilities.Early pregnancy

IVIG – IVIG stands for Intravenous Immunoglobulin.
Low retic is observed in infants treated with IUT and in those with HDN from anti-Kell. Neutrophils – as neutropenia is one of the complications of HDN, the neutrophil count should be checked. Thrombocytes - as thrombocytopenia is one of the complications of HDN, the thrombocyte count should be checked. Bilirubin should be tested from cord blood. Ferritin – because most infants affected by HDN have iron overload, a ferritin must be run before giving the infant any additional iron. Newborn Screening Tests – Transfusion with donor blood during pregnancy or shortly after birth can affect the results of the Newborn Screening Tests. It is recommended to wait and retest 10–12 months after last transfusion. In some cases, DNA testing from saliva can be used to rule out certain conditions. Treatment
After birth, treatment depends on the severity of the condition, but could include temperature stabilization and monitoring, phototherapy, transfusion with compatible packed red blood, exchange transfusion, sodium bicarbonate for correction of acidosis and/or assisted ventilation. Phototherapy – Exposure to ultraviolet light (phototherapy) is recommended when the cord bilirubin is 3 or higher. Some doctors use it at lower levels while awaiting lab results. This converts unconjugated bilirubin to an conjugated form that is easier for the infant to clear. IVIG - IVIG has been used to successfully treat many cases of HDN. It has been used not only on anti-D, but on anti-E as well. IVIG can be used to reduce the need for exchange transfusion and to shorten the length of phototherapy.