The Development of Immunological Factors in Infants with Hyperbilirubinemia

PEDIATRICS ◽  
1970 ◽  
Vol 45 (1) ◽  
pp. 102-104
Author(s):  
Zdenka Nejedlá
Keyword(s):  
Exchange Transfusion ◽  
Causative Factor ◽  
Neonatal Hyperbilirubinemia ◽  
Control Group ◽  
Abo Incompatibility ◽  
Healthy Infants ◽  
Significant Depression ◽  
Immunological Factors ◽  
Antibody Levels

Twelve infants with neonatal hyperbilirubinemia caused by Rh or ABO incompatibility were followed for 1 year after birth. Antibodv determinations for diphtheria, tetanus, pertussis and three strains of E. coil (026, 055, and 079) were done. The results were compared with those from a control group of 25 healthy infants and from 40 infants who had received exchange transfusion after birth. The data suggests that bilirubin is a causative factor in the significant depression of antibody levels against diphtheria, tetanus, and pertussis in infants with hyperbilirubinemia when compared to healthy infants. [see pdf for figures]

scholarly journals Exchange Transfusion for Neonatal Hyperbilirubinemia in Johannesburg, South Africa, from 2006 to 2011

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Daynia E. Ballot ◽  
Gilbert Rugamba
Keyword(s):  
South Africa ◽  
Mechanical Ventilation ◽  
Retrospective Review ◽  
Neonatal Sepsis ◽  
Exchange Transfusion ◽  
Neonatal Hyperbilirubinemia ◽  
Significant Complication ◽  
Abo Incompatibility

Background. Severe hyperbilirubinaemia requiring exchange transfusion has become less common in recent years; however, kernicterus still occurs. The aim of this study was to review babies undergoing exchange transfusion for severe hyperbilirubinaemia in a Johannesburg hospital. Methodology. This was a retrospective review of babies who required exchange transfusion in both the neonatal and the paediatric wards from June 1, 2006, to December 31, 2011. Results. There were 64 patients who underwent 67 exchange transfusions. Isoimmune haemolysis (both Rh and ABO incompatibility) was the cause of jaundice in 9/64 (14%). Most babies who underwent exchange transfusion were sick or preterm and were admitted in hospital after birth (38/64; 59.5%); three of these babies died, but not during the exchange transfusion (3/38; 7.9%); all three had signs suggestive of neonatal sepsis. The remaining 26 babies (40.6%) were readmitted to the paediatric wards for exchange transfusion. Six of these babies (6/26; 23.0%) had signs of kernicterus. The most significant complication of exchange transfusion was apnoea requiring mechanical ventilation in three patients (3/64; 4.6%). Conclusion. Despite a relatively low number of babies undergoing exchange transfusion, kernicterus still occurs and must be prevented. Proper protocols for screening and management of severe hyperbilirubinaemia need to be enforced.

scholarly journals Identification of Genetic Risk Factors for Neonatal Hyperbilirubinemia in Fujian Province, Southeastern China: A Case-Control Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jinfu Zhou ◽  
Changyi Yang ◽  
Wenbin Zhu ◽  
Shuwei Chen ◽  
Yinglin Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Genetic Risk ◽  
G6pd Deficiency ◽  
Genetic Risk Factors ◽  
Neonatal Hyperbilirubinemia ◽  
Control Group ◽  
Case Group ◽  
Southeastern China ◽  
Abo Incompatibility ◽  
Control Study

To date, the genetic risk factors for neonatal hyperbilirubinemia remain unknown in Southeastern China. This case-control study aimed to identify the genetic risk factors for neonatal hyperbilirubinemia in Fujian, Southeastern China. A total of 286 hyperbilirubinemic newborns were enrolled as a case group, and 250 randomly selected newborns without jaundice or with a bilirubin level that was lower than the threshold required for phototherapy served as controls. The serum levels of total bilirubin, unconjugated bilirubin, and direct bilirubin were measured, and the common genetic loci in UGT1A1, OATP1B1, and HO-1 genes were genotyped. Higher incidence of ABO incompatibility and G6PD deficiency was detected in the case group compared to the control group (P < 0.01). There were significant differences in the frequencies of rs4148323 and rs1805173 genotypes between the case and control groups (P < 0.05). At the rs4148323 locus, the frequencies of GA heterozygotes and AA mutant homozygotes were higher in the case group than in the control group (P < 0.05), and at the rs1805173 locus, the frequencies of LS, MS, and SS genotypes were higher in the case group than in the control group (P < 0.05). A higher frequency of rs4148323 A allele and rs1805173 S allele was detected in the case group compared to the control group (P = 0). Additionally, multivariate logistic regression analysis identified that the mutant genotype of rs4148323 in the UGT1A1 gene, ABO incompatibility, G6PD deficiency, and SS genotype at rs1805173 locus of the HO-1 gene were genetic risk factors of neonatal hyperbilirubinemia. Our data demonstrate that G211 mutation in the UGT1A1 gene, ABO incompatibility, G6PD deficiency, and the SS genotype of the repeats in the promoter region of the HO-1 gene are risk factors for neonatal hyperbilirubinemia in Fujian, Southeastern China.

scholarly journals Effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion in treating neonatal jaundice at Fatima Al-Zahra Hospital for maternity and children in Baghdad

2020 ◽  
Vol 16 (2) ◽  
pp. 25-29
Author(s):  
Ahmed Salih Marzoog ◽  
Hussein Naeem Mohammed ◽  
Kholod Dhaher Habib
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Neonatal Care ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Common Disease ◽  
Female Ratio ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Neonatal Care Unit

Background: Neonatal hyperbilirubinemia is a common disease in neonates especially in early days of birth that requires a good and successful treatment for reducing the severity and its complications that can produce important and irreversible effects. Objectives: To evaluate the effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion on outcomes of neonatal jaundice at Fatima Al-Zahra Hospital for maternity and child care in Baghdad. Patients & Methods: A retrospective study was carried out using medical records of neonates with diagnosis of unconjugated jaundice, admitted in the septic neonatal care unit of Fatima Al-Zahra hospital over 6 months period between 1st May till 31st October 2018. The total serum bilirubin, fractionations and blood group were done in all cases. They treated with conventional phototherapy, intensive phototherapy and exchange transfusion according to the severity of jaundice. Results: Total neonates admitted from 1st may to 31st October 2018 in septic neonatal care unit were 1254, among them 432 (35%) were diagnosed as unconjugated neonatal jaundice “indirect hyperbilirubinemia”. Male: Female ratio (1.4:1), males 256(59.3%), females 176(40.7%). Physiological jaundice was the most common cause 129(29.9%) cases. Prematurity in 104(24.1%) and ABO incompatibility 59(13.7%) while Rh incompatibility 14(3.2%), sepsis 8(1.9%) and unknown causes of jaundice were 118(27.3%) because lack of lab facilities. Conventional phototherapy was the most common kind of treatment in 237(55%) while intensive phototherapy used in 175(40.3%) cases with successful reduction in T.S.B level and the rate of improvement without need for exchange transfusion (92%) (161/175).Only 20(4.5%) cases were treated with exchange transfusion especially for ABO incompatibility 8 (42.1%) cases and Rh incompatibility 4 (21.1%) cases. Most of neonates 429 (99.3%) discharged with complete improvement and only 2 (0.5%) neonates suffered from kernicterus and one death (0.2%). Conclusion: Conventional phototherapy is still the standard treatment of mild to moderate indirect hyperbilirubinemia. Use of intensive phototherapy in the treatment of unconjugated neonatal hyperbilirubinemia is effective in reducing T.S.B level, need for exchange transfusion and hospital staying. Recommendations: provide aseptic neonatal care unit in the hospital with further number of intensive phototherapy devices as it is so effective in treating unconjugated neonatal jaundice and reduces need for exchange transfusion as it is proven in the study.

Neonatal Hyperbilirubinemia Associated With Glucose-6-Phosphate Dehydrogenase Deficiency in Sephardic-Jewish Neonates: Incidence, Severity, and the Effect of Phototherapy

PEDIATRICS ◽  
1992 ◽  
Vol 90 (3) ◽  
pp. 401-405
Author(s):  
Michael Kaplan ◽  
Ayala Abramov
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Statistical Significance ◽  
Neonatal Hyperbilirubinemia ◽  
Control Group ◽  
Serum Total Bilirubin ◽  
Study Group ◽  
Show Evidence ◽  
Term Newborns ◽  
Glucose 6 Phosphate Dehydrogenase

Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is frequently associated with neonatal hyperbilirubinemia, and sometimes kernicterus, often in the absence of any identifiable trigger or hematological evidence of hemolysis. The aim of this study was to compare the incidence and severity of, and the effect of phototherapy on, jaundice in G-6-PD-deficient vs G-6-PD-normal neonates in the Sephardic-Jewish community. Healthy term newborns, born to mothers of families stemming from geographic areas known to be "at risk" for G-6-PD deficiency, were screened for the condition and surveyed for hyperbilirubinemia. Seventy-five G-6-PD-deficient neonates formed the study group, while 266 neonates with normal levels of the enzyme formed the control group. Neonates with any other identifiable cause for jaundice were excluded. Phototherapy was commenced when the serum bilirubin levels reached 16 mg/dL (274 µmol/L) or more, and it was discontinued at 12 mg/dL (205 µmol/L) or less. Hyperbilirubinemia developed in 27 (36%) of the deficient neonates (serum total bilirubin &gt;13.9 mg/dL [238 µmol/L]), compared with 50 (18.8%) of control neonates (P = .002), while 20 (26.7%) of the study group required phototherapy, compared with 31 (11.7%) of control neonates (P = .002). Two neonates in the study group required exchange transfusion (serum bilirubin &gt;20 mg/dL [342 µmol/L]), vs 0 in the control group (not significant). Further analysis was performed on male neonates only: despite a tendency for the hyperbilirubinemia to behave differently with regard to peak bilirubin levels, age at the time of the peak, duration of phototherapy, and rate of bilirubin decrease during phototherapy, these differences failed to attain statistical significance. Values for hematocrit and reticulocyte count did not show evidence of overt hemolysis. Routine daily clinical evaluation and use of phototherapy according to the above criteria made it possible to keep the need for exchange transfusion to a minimum and to prevent kernicterus in this population.

Serum Endocan, Neuron-Specific Enolase and Ischemia-Modified Albumin Levels in Newborns with Partial Blood Exchange Transfusion

2020 ◽  
Vol 23 ◽  
Author(s):  
Erbu Yarci ◽  
Cuneyt Tayman ◽  
Ufuk Cakir ◽  
Utku Serkant
Keyword(s):  
Exchange Transfusion ◽  
Neuronal Damage ◽  
Neuron Specific Enolase ◽  
Endothelial Damage ◽  
Control Group ◽  
Control Groups ◽  
Term Neonates ◽  
Blood Exchange ◽  
Blood Exchange Transfusion ◽  
And Control

Background:: Hyperviscosity of blood secondary to polycythemia results in increased resistance to blood flow and decrease in delivery of oxygen. Objective:: To evaluate whether serum endocan, NSE and IMA levels can be compared in terms of endothelial injury/ dysfunction and neuronal damage in term neonates with polycythemia who underwent PET. Methods:: 38 symptomatic polycythemic newborns having PET and 38 healthy newborns were included in the study. Blood samples for endocan, NSE and IMA were taken at only postnatal 24 hours of age in the control group and in polycytemia group just before PET, at 24 and 72 hours after PET. Results:: The polycythemia group had higher serum endocan(1073,4 ± 644,8 vs. 378,8 ± 95,9ng/ml; p<0.05), IMA(1,32 ± 0,34 vs.0,601 ± 0,095absorbance unit; p<0.05) and NSE(44,7 ± 4,3 vs. 26,91 ± 7,12μg/l; p<0.05) levels than control group before the PET procedure. At 24 hours after PET, IMA(0,656 ± 0,07 vs. 0,601 ± 0,095absorbance unit; p<0.05) and endocan(510,9 ± 228,6 vs. 378,8 ± 95,9ng/ml; p<0.05) levels were closer to the control group, being still statistically significant higher. NSE levels decreased to control group levels having no difference between the PET and control groups at 24 hours after PET (28,98 ± 6,5 vs. 26,91 ± 7,12μg/l; p>0.05). At 72 hours after PET the polycythemia and control groups did not differ statistically for IMA, endocan and NSE levels (p>0.05). Conclusion:: Serum endocan and IMA levels can be used as a biomarker for endothelial damage / dysfunction and tissue hypoxia in infants with symptomatic polycytemia.

scholarly journals The role of peripheral type 2 innate lymphoid cells in bronchiolitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong-Jun Tang ◽  
Li-Li Xie ◽  
Xiang-Rong Zheng ◽  
Chen-Tao Liu ◽  
Xia Wang
Keyword(s):  
Statistical Significance ◽  
Serum Levels ◽  
Innate Lymphoid Cells ◽  
Lymphoid Cells ◽  
Orphan Receptor ◽  
Control Group ◽  
Interleukin 5 ◽  
Healthy Infants ◽  
Significant Difference

AbstractOur aim was to detect type 2 innate lymphoid cells (ILC2s)-related cytokines of infants with bronchiolitis by using Elisa, Liquidchip technology and RT-PCR and investigated its correlation with bronchiolitis. We recruited 26 infants with bronchiolitis and 20 healthy infants as control from Xiangya Hospital. Compared to the control group, the serum levels of interleukin-5 (IL-5) [41.99 (21.11) vs 25.70 (19.64)], IL-9 [27.04 (37.51) vs 8.30 (0.54)], IL-13 [184.05 (132.81) vs 121.75 (176.13)], IL-33 [83.70 (46.69) vs 11.23 (55.31)] and thymic stromal lymphopoietin (TSLP) [31.42 (5.41) vs 28.76 (2.56)] were significantly increased in infants with bronchiolitis (P < 0.05), while the level of IgE had no significant difference between the two groups [19.05 (14.15) vs 14.85 (20.2), P > 0.05]. The mRNA expression of IL-17RB (9.83 ± 0.35 vs 9.19 ± 0.58), TSLP (16.98 ± 2.12 vs 15.07 ± 2.25), retinoid acid receptor related orphan receptor α (7.18 ± 0.71 vs 5.46 ± 1.09) and trans-acting T-cell-specific transcription factor 3 (4.86 ± 0.66 vs 4.19 ± 0.90) were significantly increased in infants with bronchiolitis versus the control group (P < 0.05), while there was no statistical significance for suppression of tumorigenicity 2 (5.59 ± 0.68 vs 5.41 ± 0.87, P > 0.05). Our findings suggested that ILC2s possibly play a specific role in immunopathology of bronchiolitis.

In-line filtration reduced phlebitis associated with peripheral venous cannulation: Focus on cost-effectiveness and patients’ perspectives

2019 ◽  
Vol 21 (2) ◽  
pp. 154-160
Author(s):  
Gianluca Villa ◽  
Rosa Giua ◽  
Timothy Amass ◽  
Lorenzo Tofani ◽  
Cosimo Chelazzi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vascular Access ◽  
Cost Effective ◽  
Causative Factor ◽  
Control Group ◽  
Previous Trial ◽  
Venous Cannulation ◽  
Group A ◽  
The Cost ◽  
And Control

Background: In a previous trial, in-line filtration significantly prevented postoperative phlebitis associated with short peripheral venous cannulation. This study aims to describe the cost-effectiveness of in-line filtration in reducing phlebitis and examine patients’ perception of in-hospital vascular access management with and without in-line filtration. Methods: We analysed costs associated with in-line filtration: these data were prospectively recorded during the previous trial. Furthermore, we performed a follow-up for all the 268 patients enrolled in this trial. Among these, 213 patients responded and completed 6 months after hospital discharge questionnaires evaluating the perception of and satisfaction with the management of their vascular access. Results: In-line filtration group required 95.60€ more than the no-filtration group (a mean of € 0.71/patient). In terms of satisfaction with the perioperative management of their short peripheral venous cannulation, 110 (82%) and 103 (76.9%) patients, respectively, for in-line filtration and control group, completed this survey. Within in-line filtration group, 97.3% of patients were satisfied/strongly satisfied; if compared with previous experiences on short peripheral venous cannulation, 11% of them recognised in-line filtration as a relevant causative factor in determining their satisfaction. Among patients within the control group, 93.2% were satisfied/strongly satisfied, although up to 30% of them had experienced postoperative phlebitis. At the qualitative interview, they recognised no difference than previous experiences on short peripheral venous cannulation, and mentioned postoperative phlebitis as a common event that ‘normally occurs’ during a hospital stay. Conclusion: In-line filtration is cost-effective in preventing postoperative phlebitis, and it seems to contribute to increasing patient satisfaction and reducing short peripheral venous cannulation–related discomfort

scholarly journals Waning Humoral Response 3 to 6 Months after Vaccination with the SARS-COV-2 BNT162b2 mRNA Vaccine in Dialysis Patients

2021 ◽  
Vol 11 (1) ◽  
pp. 64
Author(s):  
Noa Berar-Yanay ◽  
Sarit Freiman ◽  
Maʹanit Shapira ◽  
Amer Saffoury ◽  
Ameer Elemy ◽  
...  
Keyword(s):  
Response Rate ◽  
Vaccine Dose ◽  
Humoral Response ◽  
Albumin Level ◽  
High Response Rate ◽  
Control Group ◽  
Dialysis Patients ◽  
Serious Adverse Events ◽  
Antibody Levels

Background and objectives: The short-term reported antibody response to SARS-COV-2 vaccination in dialysis patients is high, with a seroconversion response rate up to 97%. Data on the long-term durability of this response are scarce. Our objective was to characterize the long-term anti-spike antibody level in dialysis patients. Design, setting, participants, and measurements: In an observational study, we measured SARS-COV-2 anti-spike antibody levels in dialysis patients who completed 2 doses of the BNT162b2 mRNA SAR S-COV-2 vaccine at 1, 3 and 6 months after the second vaccine dose. We compared the response to dialysis patients who were infected with COVD-19 and to a control group of healthcare-employees. Results: One hundred and forty-two dialysis patients who had been vaccinated (ages 64 ± 11.9 years, 61% male), 33 dialysis patients who had COVID-19 infection (ages 54 ± 14.3 years, 55% male) and 104 individuals in the control group (ages 50 ± 12.2 years, 44% male) were included. The response rate in the vaccinated dialysis patients was 94%, 78% and 73% at 1, 3 and 6 months after the second vaccine dose. In the COVID-19 infected dialysis group and in the control group, the response rate remained at 100% over 6 months. The percentage of change in antibody levels between one and 6 months was −66% in the vaccinated dialysis group, −28% in the control group (p < 0.001) and +48% in dialysis patients who had been infected with COVID-19 (p < 0.001). A non-responder status at 6 months was associated with a lower albumin level. No serious adverse events following vaccination were reported. In conclusion: the initially high response rate to the BNT162b2 vaccine in dialysis patients decreases rapidly. Our results indicate that an early booster (3rd) dose, at three months after the second dose, may be advised for this population to preserve the humoral immunity.

Phototherapy for Neonatal Jaundice in Erythrocyte Glucose-6-Phosphate Dehydrogenase-Deficient Infants

PEDIATRICS ◽  
1977 ◽  
Vol 59 (6) ◽  
pp. 1023-1026
Author(s):  
K. L. Tan
Keyword(s):  
G6pd Deficiency ◽  
Neonatal Jaundice ◽  
Significant Rise ◽  
Neonatal Hyperbilirubinemia ◽  
Control Group ◽  
Rapid Rise ◽  
Glucose 6 Phosphate Dehydrogenase

The effectiveness of phototherapy in the management of neonatal hyperbilirubinemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient infants was studied. "Prophylactic" phototherapy for six continuous days commencing from the first day of life was effective in preventing a significant rise in bilirubin levels in 12 G6PD-deficient infants in the first three days, during which period a rapid rise was observed in a control group of G6PD-deficient infants. The hemoglobin levels on the first and eighth postnatal days were comparable in both groups. "Therapeutic" phototherapy proved equally effective in reducing bilirubin levels in 24 infants with nonhemolytic hyperbilirubinemia and an equal number of infants with hyperbilirubinemia associated with G6PD deficiency. Phototherapy was efficacious in the prevention or treatment of neonatal hyperbilirubinemia associated with G6PD deficiency; even if its use is prolonged it does not cause hemolysis in such infants.

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