Recombinant Erythropoietin as Treatment for the Late Hyporegenerative Anemia of Rh Hemolytic Disease

Ohls, RK; Pe, Wirkus; Rd, Christensen

doi:10.1542/peds.90.5.678

Cited by 38 publications

(1 citation statement)

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“…Other case reports have described the use of RHuEPO in patients with late hypo-regenerative anemia in the setting of receiving intrauterine transfusions. In 2 cases described by Ohls et al, 10 hematocrit dropped as low as 19% and 22%. Scaradavou et al 11 describe patients in which hemoglobin has dropped to <5 g/dL and hematocrits that have been documented as low as 15%.…”

Section: Discussionmentioning

confidence: 88%

Case of Hemolytic Disease of the Fetus and Newborn Treated Without Blood Products

Hirschman,

Munchel

2023

Journal of Pediatric Hematology/Oncology

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Hemolytic disease of the fetus and newborn (HDFN) affects 3/100,000 to 80/100,000 patients yearly and can cause severe anemia and hyperbilirubinemia. Recombinant human erythropoietin has been used as an adjunct therapy in patients with HDFN and hypo-regenerative anemia in the setting of receiving intrauterine blood transfusions. This case describes a patient with HDFN, in which the family were Jehovah Witnesses, and blood transfusions were declined. The patient had symptomatic anemia with a hematocrit nadir of 18.6%. The patient was successfully treated with recombinant human erythropoietin, ferrous sulfate, and folic acid, avoiding the need for transfusion.

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Section: Discussionmentioning

confidence: 88%

Case of Hemolytic Disease of the Fetus and Newborn Treated Without Blood Products

Hirschman,

Munchel

2023

Journal of Pediatric Hematology/Oncology

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Erythropoietin in Cardiac Surgery

Helm¹,

Kreiger²

1998

Blood Conservation in Cardiac Surgery

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Haemolytic disease of newborn

Narang

Jain

2001

Indian J Pediatr

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Hemolytic disease of the newborn (HDN) occurs due to maternal IgG antibodies crossing the placenta thereby producing hemolysis mainly due to Rh, ABO and Kell groups. A systematic approach to the Rh HDN involves an obstetric history of previous isoimmunized baby, timing and regular monitoring of maternal Rh antibodies and pigment assay of amniotic fluid. Timely decision regarding in utero transfusion and early termination of pregnancy based on the maternal monitoring has radically improved the outcome of these babies. Antenatal prophylaxis with anti D has resulted in great reduction in the magnitude of Rh problem. The fetal blood sampling and in-utero intravenous transfusions has made it possible for almost 100% survival of isoimmunized pregnancies without hydrops. Alternative methods--IVIG and plasma exchange are still of limited application. ABO HDN though common is not a serious form of disease and dose not warrants invasive antenatal monitoring. Anti-Kell is found in patients having received multiple transfusions and the rapid progress of hemolysis in them may not allow such systematic follow up as in Rh HDN.

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Recombinant Erythropoietin as Treatment for the Late Hyporegenerative Anemia of Rh Hemolytic Disease

Cited by 38 publications

References 0 publications

Case of Hemolytic Disease of the Fetus and Newborn Treated Without Blood Products

Case of Hemolytic Disease of the Fetus and Newborn Treated Without Blood Products

Erythropoietin in Cardiac Surgery

Haemolytic disease of newborn

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