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Ercin S, Coskun Y, Kayas K, Kavas N, Gursoy T. Positive Direct Antiglobulin Test: Is It a Risk Factor for Significant Hyperbilirubinemia in Neonates with ABO Incompatibility? Am J Perinatol 2024; 41:505-510. [PMID: 34847590 DOI: 10.1055/a-1709-5036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE ABO blood group (ABO) incompatibility is a common cause of neonatal indirect hyperbilirubinemia. The direct antiglobulin test (DAT) can identify infants developing hemolytic disease. This study aims to evaluate the significance of DAT positivity among neonates with ABO incompatibility. STUDY DESIGN This retrospective study included 820 neonates with blood group A or B who were born to blood group O mothers. The study group consisted of neonates (n = 79) who had positive DAT, and the control group consisted of infants (n = 741) who had negative DAT. Demographic and clinical data of the neonates regarding jaundice were collected and compared statistically. RESULTS The bilirubin level at 24 hours of life (study group: 8 ± 2.6 mg/dL, control group: 6 ± 2.2 mg/dL, p < 0.001) and the highest bilirubin level (study group: 12.7 ± 3.6 mg/dL, control group: 10.4 ± 4.2 mg/dL, p < 0.001) were higher in infants with positive DAT. A total of 37 (46.8%) infants in the study group and 83 (11.2%) infants in the control group received phototherapy (PT) in the nursery (p < 0.001). In neonates with positive DAT, direct bilirubin level, duration of hospitalization, and PT in the nursery were higher (p = 0.002, <0.001, and <0.001, respectively), whereas hemoglobin level was lower (p < 0.001). CONCLUSION In neonates with ABO incompatibility, a positive DAT is a risk factor for developing significant hyperbilirubinemia. Close follow-up of newborn infants with ABO incompatibility is crucial for early detection and treatment of neonatal jaundice to avoid early and late complications. KEY POINTS · The clinical spectrum of ABO incompatibility varies widely.. · The ABO incompatibility with positive DAT are at greater risk for high bilirubin levels.. · Infants with blood group incompatibilities must be monitored closely..
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Affiliation(s)
- Secil Ercin
- Division of Neonatology, Department of Pediatrics, Koc University Hospital, Istanbul, Turkey
| | - Yesim Coskun
- Department of Pediatrics, Koc University Hospital, Istanbul, Turkey
| | - Kalender Kayas
- Department of Pediatrics, Koc University Hospital, Istanbul, Turkey
| | - Nazan Kavas
- Division of Neonatology, Department of Pediatrics, Koc University Hospital, Istanbul, Turkey
| | - Tugba Gursoy
- Division of Neonatology, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
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Zheng Y, Almeyda-Alejo Y, Tumin D, Redpath NSJ, Guillen-Hernandez J. Three or four doses of intravenous immunoglobulin G treatment for isoimmune hemolytic disease: A case series and literature review. J Neonatal Perinatal Med 2024; 17:153-158. [PMID: 38143377 DOI: 10.3233/npm-230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Neonates affected by isoimmune hemolytic disease (HDN) are at risk of developing severe hyperbilirubinemia. Studies show that increasing levels of bilirubin impact neonatal neurodevelopment. To avoid complications associated with exchange transfusion, intravenous immunoglobulin G (IVIG) is used to treat hyperbilirubinemia. We included all infants who received more than two doses of IVIG treatment for isoimmune hemolytic disease. We analyzed the incidence of side effects associated with IVIG treatment and the rate of exchange transfusion. METHODS A retrospective chart review performed between October 2011-October 2022 at East Carolina University Health identified neonates who received more than two doses IVIG for HDN. Neonates of postmenstrual age greater than 28 days old, receiving less than three doses of IVIG or received IVIG for other indications were excluded. The occurrences of adverse events, demographics and use of other medical therapies were reviewed. RESULTS Eleven neonates were included in the case series. Most common cause of severe hyperbilirubinemia was attributed to ABO incompatibility. Six patients (54%) received three doses of IVIG, and five patients (45%) received four doses of IVIG with bilirubin levels decreasing below exchange transfusion. No treatment exceeding four doses of IVIG was reported, nor adverse events during treatment. CONCLUSIONS In this cohort of neonates with HDN, bilirubin levels decreased after treatment with multiple doses of IVIG. Future research on recommendations of optimal total number doses of IVIG to reduce the risk for exchange transfusion.
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Affiliation(s)
- Y Zheng
- Department of Neonatology, East Carolina University Health Medical Center, Greenville, NC, USA
| | - Y Almeyda-Alejo
- Department of Pediatrics, East Carolina University Health Medical Center, Greenville, NC, USA
| | - D Tumin
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - N S J Redpath
- Department of Neonatology, East Carolina University Health Medical Center, Greenville, NC, USA
| | - J Guillen-Hernandez
- Department of Neonatology, East Carolina University Health Medical Center, Greenville, NC, USA
- Department of Pediatrics, East Carolina University Health Medical Center, Greenville, NC, USA
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA
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Rasiah S, Jegathesan T, Campbell DM, Shah PS, Sgro MD. Intravenous immunoglobulin G therapy for neonatal hyperbilirubinemia. Pediatr Res 2023; 94:2092-2097. [PMID: 37491586 PMCID: PMC10665189 DOI: 10.1038/s41390-023-02712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Neonatal hyperbilirubinemia (NHb) results from increased total serum bilirubin and is a common reason for admission and readmission amongst newborn infants born in North America. The use of intravenous immunoglobulin (IVIG) therapy for treating NHb has been widely debated, and the current incidence of NHb and its therapies remain unknown. METHODS Using national and provincial databases, a population-based retrospective cohort study of infants born in Ontario from April 2014 to March 2018 was conducted. RESULTS Of the 533,084 infants born in Ontario at ≥35 weeks gestation, 29,756 (5.6%) presented with NHb. Among these infants, 80.1-88.2% received phototherapy, 1.1-2.0% received IVIG therapy and 0.1-0.2% received exchange transfusion (ET) over the study period. Although phototherapy was administered (83.0%) for NHb, its use decreased from 2014 to 2018 (88.2-80.1%) (P < 0.01). Similarly, the incidence of IVIG therapy increased from 71 to 156 infants (1.1-2.0%) (P < 0.01) and a small change in the incidence of ET (0.2-0.1%) was noted. CONCLUSION IVIG therapy is increasingly being used in Ontario despite limited studies evaluating its use. The results of this study could inform treatment and management protocols for NHb. IMPACTS Clinically significant neonatal hyperbilirubinemia still occurs in Ontario, with an increasing number of infants receiving Intravenous Immunoglobulin G (IVIG) therapy. IVIG continues to be used at increasing rates despite inconclusive evidence to recommend its use. This study highlights the necessity of a future prospective study to better determine the effectiveness of IVIG use in treating neonatal hyperbilirubinemia, especially given the recent shortage in IVIG supply in Ontario. The results of this study could inform treatment and management protocols for neonatal hyperbilirubinemia.
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Affiliation(s)
- Saisujani Rasiah
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Thivia Jegathesan
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Douglas M Campbell
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Prakeshkumar S Shah
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael D Sgro
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada.
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
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黄 方, 何 洋, 唐 军, 张 萌, 陈 剑, 母 得. [Interpretation of "International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn"]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:1183-1188. [PMID: 36398541 PMCID: PMC9678070 DOI: 10.7499/j.issn.1008-8830.2205158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023]
Abstract
International guidelines regarding the role of intravenous immunoglobulin (IVIG) in the management of Rh- and ABO-mediated haemolytic disease of the newborn was drafted by an international panel of experts in the fields of hematology, neonatology, and blood transfusion and was published in British Journal of Haematology on March 16, 2022. The guidelines summarize the evidence-based practice of IVIG in Rh- and ABO-mediated haemolytic disease of the newborn and propose related recommendations. The guidelines recommend that IVIG should not be applied as a routine treatment regimen for Rh- and ABO-mediated haemolytic disease of the newborn in order to reduce exchange transfusion (ET), and the best time to apply IVIG remains unclear in the situations where hyperbilirubinaemia is severe (approaching or exceeding the ET threshold) or ET cannot be implemented. These guidelines are formulated with rigorous methods, but with the lower quality of evidence.
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Lieberman L, Lopriore E, Baker JM, Bercovitz RS, Christensen RD, Crighton G, Delaney M, Goel R, Hendrickson JE, Keir A, Landry D, La Rocca U, Lemyre B, Maier RF, Muniz‐Diaz E, Nahirniak S, New HV, Pavenski K, dos Santos MCP, Ramsey G, Shehata N. International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn. Br J Haematol 2022; 198:183-195. [PMID: 35415922 PMCID: PMC9324942 DOI: 10.1111/bjh.18170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/16/2022] [Indexed: 01/08/2023]
Abstract
Haemolytic disease of the newborn (HDN) can be associated with significant morbidity. Prompt treatment with intensive phototherapy (PT) and exchange transfusions (ETs) can dramatically improve outcomes. ET is invasive and associated with risks. Intravenous immunoglobulin (IVIG) may be an alternative therapy to prevent use of ET. An international panel of experts was convened to develop evidence-based recommendations regarding the effectiveness and safety of IVIG to reduce the need for ETs, improve neurocognitive outcomes, reduce bilirubin level, reduce the frequency of red blood cell (RBC) transfusions and severity of anaemia, and/or reduce duration of hospitalization for neonates with Rh or ABO-mediated HDN. We used a systematic approach to search and review the literature and then develop recommendations from published data. These recommendations conclude that IVIG should not be routinely used to treat Rh or ABO antibody-mediated HDN. In situations where hyperbilirubinaemia is severe (and ET is imminent), or when ET is not readily available, the role of IVIG is unclear. High-quality studies are urgently needed to assess the optimal use of IVIG in patients with HDN.
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Affiliation(s)
- Lani Lieberman
- Department of Clinical PathologyUniversity Health NetworkTorontoOntarioCanada
- Department of Laboratory Medicine & PathobiologyUniversity of TorontoTorontoOntarioCanada
- Department of Laboratory Medicine and Molecular DiagnosticsSunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Enrico Lopriore
- Division of NeonatologyDepartment of Pediatrics, Leiden University Medical CenterLeidenThe Netherlands
| | - Jillian M. Baker
- Department of PediatricsUnity Health Toronto (St. Michael's Hospital)TorontoOntarioCanada
- Division of Haematology‐OncologyThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Rachel S. Bercovitz
- Division of HematologyOncology, and Stem Cell Transplant, Department of Pediatrics, Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Robert D. Christensen
- Divisions of Neonatology and Hematology/OncologyUniversity of Utah HealthSalt Lake CityUTUSA
- Department of Women and Newborn's ResearchIntermountain HealthcareSalt Lake CityUtahUSA
| | - Gemma Crighton
- Department of HaematologyRoyal Children's HospitalMelbourneAustralia
| | - Meghan Delaney
- Division of Pathology & Laboratory MedicineChildren's National HospitalWashingtonDistrict of ColumbiaUSA
- Department of Pathology & PediatricsThe George Washington University Health SciencesWashingtonDistrict of ColumbiaUSA
| | - Ruchika Goel
- Division of Transfusion MedicineDepartment of Pathology, School of Medicine, Johns Hopkins UniversityBaltimoreMarylandUSA
- Simmons Cancer Institute at SIU School of MedicineSpringfieldIllinoisUSA
| | - Jeanne E. Hendrickson
- Departments of Laboratory Medicine and PediatricsYale UniversityNew HavenConnecticutUSA
| | - Amy Keir
- SAHMRI Women and KidsSouth Australian Health and Medical InstituteNorth AdelaideSouth AustraliaAustralia
- Adelaide Medical School and the Robinson Research Institutethe University of AdelaideNorth AdelaideSouth AustraliaAustralia
| | | | - Ursula La Rocca
- Department of Translational and Precision MedicineSapienza UniversityRomeItaly
- Italian National Blood CentreNational Institute of HealthRomeItaly
| | - Brigitte Lemyre
- Department of PediatricsUniversity of OttawaOttawaOntarioCanada
| | - Rolf F. Maier
- Children's HospitalUniversity Hospital, Philipps UniversityMarburgGermany
| | - Eduardo Muniz‐Diaz
- Department of ImmunohematologyBlood and Tissue Bank of CataloniaBarcelonaSpain
| | - Susan Nahirniak
- Alberta Precision Laboratories and Department of Laboratory Medicine and PathologyUniversity of AlbertaEdmontonAlbertaCanada
| | - Helen V. New
- Clinical DirectorateNHS Blood and TransplantLondonUK
- Centre for HaematologyImperial College LondonLondonUK
| | - Katerina Pavenski
- Department of Laboratory Medicine and PathologyUnity Health Toronto (St. Michael's Hospital)TorontoOntarioCanada
| | | | - Glenn Ramsey
- Department of PathologyFeinberg School of Medicine, Northwestern UniversityChicagoIllinoisUSA
| | - Nadine Shehata
- Departments of MedicineLaboratory Medicine and Pathobiology, Institute of Health, Policy Management and Evaluation, University of Toronto, Mount Sinai HospitalTorontoOntarioCanada
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Karabulut B, Gafil EA. Hemolysis due to Alpha-Hemolytic Enterococcus Urinary Infection: A Rare Cause of Early and Severe Unconjugated Hyperbilirubinemia in a Neonate. J Pediatr Intensive Care 2021; 10:75-78. [PMID: 33585066 DOI: 10.1055/s-0040-1710055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022] Open
Abstract
The reason for reporting this case is to remind that some microorganisms may cause hemolysis leading to early and severe hyperbilirubinemia by secreting hemolysin in cases; where bilirubin levels cannot be successfully decreased despite effective phototherapy, intravenous immunoglobulin, and even exchange transfusion, or in cases of increased rebound bilirubin (although urinary tract infection is associated with increased conjugated bilirubin fraction and prolonged jaundice). The most common causes of hemolysis are ABO/Rh incompatibility and enzyme deficiencies such as glucose-6-phosphate dehydrogenase (G6PDH), pyruvate kinase (PK), and galactose-1-phosphate uridyltransferase (GALT). Our patient was a male infant, weighing 3,160 g, at 38 + 4 gestational week; he was referred to our unit with total bilirubin level of 14.7 mg/dL recorded at the postnatal 20th hour and was initiated treatment with intensive phototherapy and prepared for exchange transfusion. The G6PD, PK, and GALT enzyme levels studied at the postnatal 96th hour and reducing substances in urine were detected to be normal/negative, whereas complete urinalysis revealed pyuria (7 leukocytes per each high power field). α-hemolysis-producing 105 colony-forming unit/mL Enterobacter cloacae grew on blood agar in the urine culture. As reported in our case, hemolysin-secreting α and β-hemolytic bacteria can lead to severe and early hemolysis and unconjugated hyperbilirubinemia, as in blood type incompatibility and enzyme deficiencies.
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Affiliation(s)
- Birol Karabulut
- Division of Neonatology, Department of Pediatrics, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Esin Alpagut Gafil
- Division of Neonatology, Department of Pediatrics, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
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Jackson ME, Baker JM. Hemolytic Disease of the Fetus and Newborn: Historical and Current State. Clin Lab Med 2020; 41:133-151. [PMID: 33494881 DOI: 10.1016/j.cll.2020.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated disorder affecting neonates globally, with a range of clinical presentations from severe and life threatening to mild or even asymptomatic. Historically, HDFN has been responsible for a large proportion of perinatal mortality, and, despite advances in diagnosis and management, this morbidity and mortality has not been eradicated. Blood banking techniques and blood transfusion have contributed to improved prophylaxis and management, drastically improving the outcome of newborns with HDFN over the last century.
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Affiliation(s)
- Melanie E Jackson
- The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
| | - Jillian M Baker
- The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Unity Health Toronto (St. Michael's Hospital), 61 Queen Street East, 2nd, Floor, Toronto, Ontario M5C2T2, Canada; University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada.
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Sarihi R, Ahmadnejad M, Mohammadi S, Eshghi P, Herfat F, Jolharnejad S, Oodi A. Hemolytic disease of the fetus and newborn caused by anti-Hr 0 in a 27-year-old female with Dc- phenotype: A case report. Transfus Apher Sci 2020; 60:102913. [PMID: 32943324 DOI: 10.1016/j.transci.2020.102913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/18/2022]
Abstract
Anti-Hr0 (Anti-Rh17) is a rare immune Immunoglobulin G (IgG) to high-frequency Rh antigens that may cause severe and often fatal Hemolytic disease of the fetus and newborn (HDFN) in D--, Dc- and DCw- mothers who have been exposed to red cells of the common Rh phenotype by transfusion or pregnancy. Several pregnant women have been affected by this antibody leading to perinatal death. Therefore, immediate and effective management of these cases is of great importance. We report a case of HDFN in a 27-year-old (G5, P3, L1), woman with Rh Dc- phenotype managed successfully using intravenous immunoglobulin (IVIg) and simple transfusions.
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Affiliation(s)
- R Sarihi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - M Ahmadnejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - S Mohammadi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - P Eshghi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - F Herfat
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - S Jolharnejad
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - A Oodi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
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Al-Lawama M, Badran E, Elrimawi A, Bani Mustafa A, Alkhatib H. Intravenous Immunoglobulins as Adjunct Treatment to Phototherapy in Isoimmune Hemolytic Disease of the Newborn: A Retrospective Case-Control Study. J Clin Med Res 2019; 11:760-763. [PMID: 31803318 PMCID: PMC6879023 DOI: 10.14740/jocmr4003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 09/30/2019] [Indexed: 11/11/2022] Open
Abstract
Background Isoimmune hemolytic disease is a major cause of neonatal severe indirect hyperbilirubinemia that requires phototherapy or exchange transfusion which is an invasive procedure to avoid brain injury. Administration of intravenous immunoglobulin (IVIG) is used as an adjunct treatment to phototherapy in order to decrease the rate of exchange transfusion. Methods This retrospective case-control study aimed to describe the safety and efficacy of IVIG therapy in newborns with isoimmune hemolytic disease and to compare their clinical outcomes to those of a control group who were treated only with phototherapy. Criteria for IVIG treatment were variable; when phototherapy threshold was reached or when exchange transfusion level was approached, using either indication is based on the attending discretion. Results Ninety-four infants were included in the IVIG group, compared to 108 infants in the control group. Most of the included infants were term infants and most common cause was ABO incompatibility. There were no side effects documented in all the included infants. The IVIG group had more severe hemolysis with average highest bilirubin of 14.6 ± 3.7 mg/dL in the IVIG group versus 12.6 ± 3 in the control group (P = 0.0001). Complication of hemolysis was seen more in the IVIG group with higher rate of rebound hyperbilirubinemia, blood transfusion and exchange transfusion. Conclusions IVIG use as an adjunct treatment to phototherapy in isoimmune hemolytic disease of the newborns is safe. The favorable results of the phototherapy only group were supportive of using selective criteria for administration of IVIG in neonates with isoimmune hemolytic disease.
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Affiliation(s)
- Manar Al-Lawama
- Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Eman Badran
- Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Ala' Elrimawi
- Jordan University Hospital, The University of Jordan, Amman, Jordan
| | | | - Haitham Alkhatib
- Jordan University Hospital, The University of Jordan, Amman, Jordan
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Keir AK, Dunn M, Callum J. Should intravenous immunoglobulin be used in infants with isoimmune haemolytic disease due to ABO incompatibility? J Paediatr Child Health 2013; 49:1072-8. [PMID: 24325716 DOI: 10.1111/jpc.12440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2012] [Indexed: 11/30/2022]
Abstract
The use of intravenous immunoglobulin in isoimmune haemolytic disease due to ABO incompatibility is recommended by the American Academy of Pediatrics and the National Blood Authority, Australia. However, the evidence these recommendations are based on appears limited and, in some instances, outdated. In our article, we review the current available literature to help answer the question, 'In infants with isoimmune haemolytic disease due to ABO incompatibility [P], does use of intravenous immunoglobulin and intensive phototherapy [I] compared with intensive phototherapy alone [C] provide any clinically important benefits [O]?'
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Affiliation(s)
- Amy K Keir
- Division of Neonatology, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia
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