Intravenous Immunoglobulin Use in Hemolytic Disease Due to ABO Incompatibility to Prevent Exchange Transfusion

被引：5

作者：

Okulu, Emel

Erdeve, Omer

Kilic, Ilknur

Olukman, Ozgur

Calkavur, Sebnem

Buyukkale, Gokhan

Cetinkaya, Merih

Ulubas, Dilek

Demirel, Nihal

Hanta, Deniz

Ertugrul, Sabahattin

Gultekin, Nazli Dilay

Tuncer, Oguz

Demir, Nihat

Bilgin, Leyla

Narli, Nejat

Yildiz, Duran

Terek, Demet

Koroglu, Ozge Altun

Seren, Canan

Ozyazici, Elif

Ozdemir, Ramazan

Turgut, Hatice

Narter, Fatma

Akin, Yasemin

Ozyazici, Ahmet

Zenciroglu, Aysegul

Asker, Huseyin Selim

Gokmen, Zeynel

Salihli, Musa

Bulbul, Ali

Zubarioglu, Umut

Atasay, Begum

Koc, Esin

机构：

[1] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara

[2] Department of Neonatology, Atasehir Florence Nightingale Hospital, Istanbul

[3] Department of Neonatology, Izmir Behcet Uz Children's Hospital, University of Health Sciences, Izmir

[4] Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul

[5] Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara

[6] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara

[7] Department of Neonatology, Adana Delivery and Child Disease Hospital, Adana

[8] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Dicle University, Diyarbakir

[9] Division of Neonatology, Department of Pediatrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya

[10] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yuzuncuyil University, Van

[11] Department of Neonatology, Umraniye Research and Training Hospital, University of Health Sciences, Istanbul

[12] Neonatal Intensive Care Unit, Adana Metro Hospital, Adana

[13] Nenehatun Obstetrics and Gynecology Hospital, Erzurum

[14] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir

[15] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun

[16] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya

[17] Department of Neonatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul

[18] Department of Neonatology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara

[19] Neonatal Intensive Care Unit, NCR Hospital, Gaziantep

[20] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Konya Hospital, Başkent University, Konya

[21] Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul

[22] Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara

来源：

FRONTIERS IN PEDIATRICS | 2022年 / 10卷

关键词：

hemolytic disease of the newborn; ABO incompatibility; intravenous immunoglobulin; exchange transfusion; light-emitting diode; phototherapy; HYPERBILIRUBINEMIA; JAUNDICE; NEWBORN; PHOTOTHERAPY; KERNICTERUS; MANAGEMENT; GLOBULIN; THERAPY; TERM;

D O I：

10.3389/fped.2022.864609

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

IntroductionIntravenous immunoglobulin (IVIG) has been widely used to treat the hemolytic disease of the newborn (HDN). Although it has been shown that IVIG treatment reduces the duration of phototherapy and hospitalization, the use of IVIG in hemolytic disease due to ABO incompatibility has been controversial in recent years. This study aimed to investigate the role of IVIG in the prevention of exchange transfusion in infants with ABO HDN who presented with bilirubin levels at or above the level of exchange transfusion. Materials and MethodsThis study evaluated the data of infants with ABO HDN in the Turkish Neonatal Jaundice Online Registry. The infants with ABO HDN who met the total serum bilirubin level inclusion criteria (within 2-3 mg/dL of exchange transfusion or even above exchange transfusion level) were included in the study according to the guidelines from the American Academy of Pediatrics and the Turkish Neonatal Society. All patients were managed according to the unit protocols recommended by these guidelines and received light-emitting diode (LED) phototherapy. Infants who only received LED phototherapy, and who received one dose of IVIG with LED phototherapy were compared. ResultsDuring the study period, 531 term infants were included in the study according to inclusion criteria. There were 408 cases in the phototherapy-only group, and 123 cases in the IVIG group. The demographic findings and the mean bilirubin and reticulocyte levels at admission were similar between the groups (p > 0.05), whereas the mean hemoglobin level was slightly lower in the IVIG group (p = 0.037). The mean age at admission was earlier, the need for exchange transfusion was higher, and the duration of phototherapy was longer in the IVIG group (p < 0.001, p = 0.001, and p < 0.001, respectively). The rate of re-hospitalization and acute bilirubin encephalopathy (ABE) was higher in the IVIG group (p < 0.001 and p = 0.01, respectively). ConclusionIn this study, we determined that one dose of IVIG did not prevent an exchange transfusion nor decrease the duration of phototherapy in infants, who had bilirubin levels near or at exchange transfusion level, with hemolytic disease due to ABO incompatibility.

引用

页数：6

共 29 条

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