Hemolytic disease of the fetus and newborn

Waldron, Peter; Cashore, William J.

doi:10.1017/cbo9780511545306.008

Cited by 5 publications

(4 citation statements)

References 300 publications

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“…Third group was of other blood group HDN categorized as non-RhD and non ABO HDN, where other blood group irregular antibodies in the mother's serum were detected by indirect coomb's test (ICT) and corresponding antigen present on neonate RBCs were detected by DCT & ICT using polyspecific Coomb's serum. Other than RhD and ABO antibodies, the most common and significant antibodies causing HDN are RhC, Rhc, RhE, Kell I (K) Kell II (k), Js b , Fy a M, S & V [17,22]. Antibodies usually associated with mild to moderate HDN are Kp a , Kp b , LW, JK a , JK b , JK3, Js a , Ula, (Kel 10) Fy3, etc.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Disease of New Born (HDN) —A Study of 110 Cases

Sharma¹,

Rai²,

Iyengar³

et al. 2013

OJBD

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Aim: This study was aimed to review and establish the practice of exchange transfusion (ET) with whole blood reconstituted (WBR) in hemolytic disease of newborn (HDN). Objectives: To observe fall in indirect serum bilirubin, correction of anemia and comparison with related studies. Background: Hemolytic disease of the Newborn is characterized by presence of IgG antibodies in maternal circulation, which causes hemolysis in the fetus by crossing the placenta and sensitizing red cells for destruction by macrophages in the fetal spleen with consequent hyperbilirubinemia. Exchange transfusion with or without phototherapy is the method of choice for treating the newborn with on going hemolysis Methods/Materials: Sample size consisted of 110 neonates in whom 119 exchange transfusions were carried out with WBR. WBR was prepared by suspending O Rhesus-D (RhD) positive/negative cells (compatible with neonate's/ mother's serum) in AB plasma. Double volume exchange transfusion(s) were carried out through umbilical vein by push-pull technique. Results: Out of 110 cases, 61 (55.5%) were of RhD HDN whereas ABO and other group HDN cases were 30 (27.3%) and 19 (17.3%) respectively. An average post-ET fall in indirect serum bilirubin by 54.6% and correction of anemia by 3.7 gm/dl were reported in the study. Conclusion: An average post-ET fall in indirect serum bilirubin and correction of anemia was found to be more significant when compared to other studies. Hence we recommend exchange transfusion in HDN with WBR to obtain reasonable fall in indirect serum bilirubin and high average rate of correction of anemia.

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Section: Discussionmentioning

confidence: 99%

“…Antibodies usually associated with mild to moderate HDN are Kp a , Kp b , LW, JK a , JK b , JK3, Js a , Ula, (Kel 10) Fy3, etc. [17,22]. Vengelem Tyler V [23] studied and discussed 64 different RBC antibodies specificities reported to cause HDN.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Disease of New Born (HDN) —A Study of 110 Cases

Sharma¹,

Rai²,

Iyengar³

et al. 2013

OJBD

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“…The American Academy of Pediatrics recommended use of IVIG for hemolytic disease of the fetus and newborn which was associated with a decreased need for exchange transfusion for term and preterm infants with Rh and ABO incompatibility [2]. IVIG is used at a dose up to 1-2 g/kg.…”

Section: Discussionmentioning

confidence: 99%

Cardiac rhythm abnormalities during intravenous immunoglobulin G(IVIG) infusion in two newborn infants: coincidence or association?

Tüfekçi

Çoban

Bor

et al. 2015

Clinical Case Reports

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Key Clinical MessageWe report the occurrence of supraventricular tachycardia during intravenous immunoglobulin (IVIG) infusion. Supraventricular tachycardia was observed in two newborn patients during IVIG infusion. Both of the babies responded to adenosine treatment. Cardiorespiratory monitoring during IVIG infusion can be recommended because of the possibility of this potentially lifethreatening adverse effect.

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“…Maternal antibodies can continue to mediate HDFN following birth. While most antibodies do not remain detectable beyond 8–12 weeks post‐partum, moderate to severe cases can be characterized by hemolysis lasting beyond this timeframe 3,4 . Rare cases of persistent HDFN have been suggested to be secondary to passive transfer of maternal antibodies via breast milk 5–9 .…”

Section: Introductionmentioning

confidence: 99%

Passive transfer of alloantibodies through breast milk as a mediator of hemolytic anemia

Abels,

Jacobs,

Prior

et al. 2023

Transfusion

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BackgroundHemolytic disease of the fetus and newborn (HDFN) is characterized by destruction of fetal/neonatal red blood cells (RBCs) secondary to maternally derived antibodies, which are typically thought to be passively acquired via placental transfer. Few cases have examined the possibility of HDFN mediated by maternal antibodies passively transferred via breast milk.MethodsWe describe two cases of persistent HDFN in infants potentially mediated by passively acquired antibodies via maternal breast milk. We discuss supporting and refuting evidence that may account for this possibility and describe testing methodology illustrating how maternal alloantibodies can be detected in breast milk.ResultsIn both cases, anti‐D antibodies were detected in maternal breast milk. One patient experienced a significant decrease in anti‐D plasma titer from 64 to 4 dilutions following 2 weeks of breastfeeding cessation. The other patient experienced a resolution of anemia without breastfeeding cessation.ConclusionThere is a paucity of data regarding the lifespan of passively acquired RBC antibodies in neonatal circulation, with significant variation noted between passively acquired IgG based on studies utilizing intravenous immunoglobulin compared to studies of maternally‐acquired antiviral IgG antibodies. While our data do not definitively implicate passive transfer of alloantibodies in breast milk as a mediator of HDFN, they do illustrate the need for further investigation into the mechanisms and kinetics of passively acquired antibodies in neonatal circulation.

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Hemolytic disease of the fetus and newborn

Cited by 5 publications

References 300 publications

Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Disease of New Born (HDN) —A Study of 110 Cases

Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Disease of New Born (HDN) —A Study of 110 Cases

Cardiac rhythm abnormalities during intravenous immunoglobulin G(IVIG) infusion in two newborn infants: coincidence or association?

Passive transfer of alloantibodies through breast milk as a mediator of hemolytic anemia

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