High‐Dose Intravenous Gammaglobulin Therapy for Neonatal Immune Haemolytic Jaundice due to Blood Group Incompatibility

Sato, Katsuko; Hara, Toshiro; Kondo, T; Iwao, Haruka; Honda, Seiyo; Ueda, Kohji

doi:10.1111/j.1651-2227.1991.tb11828.x

Cited by 46 publications

(37 citation statements)

References 14 publications

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“…[61][62][63] The rationale behind this indication is that in isoimmune hemolytic disease, hyperbilirubinemia results primarily from erythrocyte phagocytosis in the reticuloendothelial system. 64 The administration of endovenous gammaglobulin would block Fc receptors from the reticuloendothelial system, decreasing the speed of hemolysis.…”

Section: Endovenous Gammaglobulinmentioning

confidence: 99%

“…62 The dose and interval of immunoglobulin administration varies from 0.5g to 1g. [61][62][63][64][65] Alpay et al treated 116 newborns with ABO and/or Rh hemolytic disease with 1g endovenous immunoglobulin (single dose). These patients required less phototherapy and fewer exchange transfusions, and spent less time in the hospital.…”

Section: Endovenous Gammaglobulinmentioning

confidence: 99%

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Treatment of neonatal hyperbilirubinemia

Carvalho¹

2001

J Pediatr (Rio J)

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Objective: to review the recent medical literature on the treatment of neonatal jaundice, focusing on practical aspects that are relevant to pediatricians and neonatologists.Sources: an extensive review of the related literature was performed, also including the author's clinical experience in this field of investigation. Summary of the findings:jaundice is very common among infants during the first days of life. Several factors such as maternal and neonatal history have to be considered before implementing treatment. Significant advances have been made in the past few years concerning the treatment of jaundiced newborn infants. This review focuses on three forms of treatment of neonatal hyperbilirubinemia: phototherapy, exchange transfusion and the use of drugs to reduce serum bilirubin concentration.Conclusions: nowadays, the in-depth knowledge about the mechanism of action of phototherapy, the development of intensified phototherapy units and the use of drugs to reduce bilirubin formation, have contributed to significantly decrease the need for exchange transfusion.

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Section: Endovenous Gammaglobulinmentioning

confidence: 99%

Section: Endovenous Gammaglobulinmentioning

confidence: 99%

Treatment of neonatal hyperbilirubinemia

Carvalho¹

2001

J Pediatr (Rio J)

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“…Recent studies [1][2][3] have demonstrated that intravenous immune globulin (IVIG) therapy is effective in modifying the hyper bilirubinemia of Coombs'-positive hemolytic anemia. While IVIG clearly reduces hyper bilirubinemia in many cases of neonatal iso immunization, it is not always successful [2], We therefore sought to elucidate the type of infant most likely to benefit from IVIG ad ministration by attempting to define pretreat ment parameters which were associated with both clinical symptomatology and therapeutic responsiveness to IVIG.…”

mentioning

confidence: 99%

Intravenous Immune Globulin in Neonatal ABO Isoimmunization: Factors Associated with Clinical Efficacy

et al. 1996

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Objective: Intravenous immune globulin (IVIG) reduces jaundice in many but not all cases of neonatal isoimmunization. We sought to elucidate the type of infant most likely to benefit from IVIG administration by attempting to define pretreatment parameters associated with both clinical symptomatology and therapeutic responsiveness to IVIG. Methods: Term, healthy Coombs-positive infants were studied prospectively. IVIG was administered if, despite phototherapy, serum bilirubin reached ≥ 222 μmol/l (13 mg/dl) at ≤ 24 h of age and/or ≥ 274 μmol/l (16 mg/dl) at > 24 h of age. Clinical data including serial serum total bilirubin levels, rate of bilirubin rise on day 1 of life, serial corrected carboxyhemoglobin levels (a sensitive indicator of hemolysis) and total hemoglobin (tHb) levels were collected. Results: Infants were classified as IVIG responders (n = 18), those in whom total serum bilirubin levels either remained stable or decreased following IVIG administration; IVIG nonresponders (n = 5), those who developed a total serum bilirubin of ≥ 2 mg/dl greater than pre-IVIG bilirubin levels within the first 24 h after IVIG administration, or nontreated, those not meeting IVIG treatment criteria (n = 13). Four of the five nonresponders proceeded to require exchange transfusion vs. none of the others (p < 0.001). Four of the five nonresponders had a pretreatment rate of bilirubin rise of > 1 mg/dl/h as compared with only 1 of 18 responders and none of the nontreated (p < 0.001). Pretreatment tHb levels were also different (13.2 ± 1.3 vs. 15.5 ± 2.3 vs. 17.7 ± 2.4 g/dl for nonresponders vs. responders vs. nontreated infants, respectively; p < 0.005). The highest pretreatment COHbc levels were seen in the nonresponders (1.8 ± 0.7 vs. 1.4 ± 0.3 vs. 0.9 ± 0.3% tHb, respectively). Conclusions: Our 3 groups represent a spectrum of hemolysis, ranging from severe to moderate to mild. This spectrum appears to relate not only to the severity of hemolysis, but also to the therapeutic responsiveness to IVIG. We speculate that some or all of the factors identified can be used prospectively to predict the subsequent clinical course of ABO-incompatible infants and to facilitate optimal management.

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“…It has been suggested that the administration of im munoglobulin in neonatal immune hyperbilirubinemia may reduce hemolysis by blockade of the Fc receptors [1][2][3]. Flowever, despite the reported reduction of bilirubin levels following IVIG treatment, the existence of such a mecha nism has not yet been proved and other explanations for the observed effect, such as enhanced excretion of bilirubin or colloid effects, remain to be examined [3].…”

Section: Introductionmentioning

confidence: 99%

“…The catabolism of heme, derived mainly from the degra dation of hemoglobin, is the sole endogenous source of carIn recent years several reports have indicated that the se verity of neonatal immune hemolytic hyperbilirubinemia may be ameliorated by the intravenous administration of high-dose immunoglobulin (IVIG), thus reducing the need for exchange transfusion [1][2][3][4], The rationale for this treat ment was based on the assumed similarity between the de structive mechanisms of antibody-sensitized erythrocytes in immune hemolytic jaundice and of antibody-sensitized platelets in neonatal immune thrombocytopenia [3,5,6], and on the beneficial therapeutic effect of high-dose IVIG treatment reported in the latter disease [7][8][9]. bon monoxide.…”

Section: Introductionmentioning

confidence: 99%

Carboxyhemoglobin Levels in Neonatal Immune Hemolytic Jaundice Treated with Intravenous Gammaglobulin

Ergaz¹,

Gross²,

Bar‐Oz³

et al. 1995

Vox Sanguinis

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In order to examine the effect of intravenous immunoglobulin (IVIG) on the rate of hemolysis in immune hemolytic hyperbilirubinemia, we measured the carboxyhemoglobin levels of 5 newborn infants who were subjected to IVIG treatment. The pretreatment rate of hemolysis, in the 5 patients with isoimmune hemolytic jaundice (3 patients with Rh hemolytic disease of the newborn and 2 patients with ABO hemolytic disease of the newborn), as reflected by caboxyhemoglobin levels was higher than the rate of hemolysis in normal newborn infants. In 4 out of the 5 patients treated with IVIG, there was a rapid decline (>30%) of carboxyhemoglobin levels, a pattern which was different from that observed in normal newborn infants with no hemolytic jaundice and in 3 untreated patients with ABO hemolytic disease of the newborn. None of the treated patients required an exchange transfusion. Our preliminary results support the theory that the attenuation of jaundice observed following IVIG treatment in patients with immune hemolytic hyperbilirubinemia is caused, at least in part, by the reduction in hemolysis.

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High‐Dose Intravenous Gammaglobulin Therapy for Neonatal Immune Haemolytic Jaundice due to Blood Group Incompatibility

Cited by 46 publications

References 14 publications

Treatment of neonatal hyperbilirubinemia

Treatment of neonatal hyperbilirubinemia

Intravenous Immune Globulin in Neonatal ABO Isoimmunization: Factors Associated with Clinical Efficacy

Carboxyhemoglobin Levels in Neonatal Immune Hemolytic Jaundice Treated with Intravenous Gammaglobulin

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