ABO Hemolytic Disease: A Comparative Study of Clinical Severity and Delayed Anemia

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 365-369 ◽  
Author(s):  
William P. Kanto ◽  
Brenda Marino ◽  
Anita S. Godwin ◽  
Chantrapa Bunyapen
Keyword(s):  
Exchange Transfusion ◽  
Reticulocyte Count ◽  
Hemoglobin Concentration ◽  
Clinical Severity ◽  
Hemolytic Disease ◽  
Bilirubin Concentration ◽  
Clinical Difference ◽  
Significant Difference ◽  
Abo Hemolytic Disease ◽  
Hemoglobin Measurement

The hospital and clinic records of 230 neonates with ABO hemolytic disease (HD) were reviewed. There was no significant difference in clinical severity between AO-HD and BO-HD as measured by (1) number of neonates with hyperbilinibinemia and/ or those requiring exchange transfusion; (2) hemoglobin concentration; (3) reticulocyte count; (4) bilirubin concentration; and (5) incidence of anemia after discharge from the hospital. There was no difference in the hemoglobin concentrations measured at between four and eight weeks of age in 39 control infants and infants with either AO-HD or BO-HD who did not require an exchange transfusion. Our data do not indicate a clinical difference in the severity of AO-HD and BO-HD. Infants with ABO-HD who do not require exchange transfusion and/or phototherapy and whose hemoglobin concentration at discharge is > 15 gm/dl do not need a hemoglobin measurement before 6 weeks of age.

Severe ABO Hemolytic Disease of the Newborn Requiring Exchange Transfusion

2019 ◽  
Vol 41 (8) ◽  
pp. 632-634 ◽  
Author(s):  
Ryan A. Metcalf ◽  
Jenna Khan ◽  
Jennifer Andrews ◽  
Dennis Mayock ◽  
Zeenia Billimoria ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Hemolytic Disease ◽  
Abo Hemolytic Disease

Study of Gilbert's Syndrome-Associated UGT1A1 Polymorphism in Jaundiced Neonates of ABO Incompatibility Hemolysis Disease

2019 ◽  
Vol 37 (06) ◽  
pp. 652-658
Author(s):  
Yingfang Yu ◽  
Lizhong Du ◽  
An Chen ◽  
Lihua Chen
Keyword(s):  
Gene Polymorphism ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Ugt1a1 Gene ◽  
Abo Incompatibility ◽  
Significant Difference ◽  
Abo Hemolytic Disease ◽  
The Relationship

Abstract Objective This study aimed to assess the probable relationship between icter in neonates with ABO incompatibility hemolysis and UGT1A1 gene polymorphism. Study Design There were 65 ABO hemolytic disease of the newborn (HDN) neonates of full term in the study group and 82 non-ABO HDN neonates of full term in the compared group. We tested the UGT1A1 gene mutation of neonates of ABO HDN and non-ABO HDN. We compared the incidence of hyperbilirubinemia between neonates with and without UGT1A1 mutations in the ABO HDN and non-ABO HDN, to determine the relationship between icter in neonates with ABO HDN and UGT1A1 gene polymorphism. SPSS 13.0 were used to analyze those two groups' data. Results There was statistically significant difference of the serum bilirubin level between the Gly71Arg homozygous and no mutation group in the ABO HDN patients (p < 0.05). When hyperbilirubinemia was defined as serum bilirubin concentration >342 μmol/L, the incidence of hyperbilirubinemia between patients of UGT1A1 and non-UGT1A1 mutations in the ABO HDN group was significantly different (p < 0.05). But in the non-ABO HDN group, no significant difference was found. Conclusion Individuals with Gly71Arg homozygous contributed to their hyperbilirubinemia in ABO HDN patients.

INDICATIONS FOR EXCHANGE TRANSFUSION BASED UPON THE ROLE OF ALBUMIN IN THE TREATMENT OF HEMOLYTIC DISEASE OF THE NEWBORN

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 749-757
Author(s):  
William J. Waters ◽  
Eva Porter
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Binding Capacity ◽  
Hemoglobin Concentration ◽  
Hemolytic Disease ◽  
History Of ◽  
Unnecessary Procedures ◽  
Previously Treated ◽  
Reserve Albumin

Maternal titer, history of previously treated sibling, positive Coombs, prematurity, cord serum bilirubin, and hemoglobin concentration do not by themselves indicate the need for immediate exchange transfusion in an infant who shows no signs of disease. The measurement of the reserve albumin binding capacity is a useful aid in determining the need for exchange transfusion in preventing bilirubin encephalopathy. A delay in treatment of infants who have an adequate reserve binding capacity does not increase the need for re-exchange and avoids unnecessary procedures. The rate of re-exchange among infants receiving added albumin and managed according to the criteria outlined was lower than in the conventionally treated series.

scholarly journals A Method of Measuring the Severity of a Series of Cases of Hemolytic Disease of the Newborn

Blood ◽  
1951 ◽  
Vol 6 (9) ◽  
pp. 777-788 ◽  
Author(s):  
P. L. MOLLISON ◽  
MARIE CUTBUSH
Keyword(s):  
Hemoglobin Concentration ◽  
Probit Analysis ◽  
Present Series ◽  
Hemolytic Disease ◽  
Bilirubin Concentration ◽  
Results Of Treatment ◽  
Sigmoid Curve ◽  
Positive Direct ◽  
Uniform Treatment ◽  
Better Than

Abstract 1. The hemoglobin concentration in the cord blood of infants affected with hemolytic disease is very closely related to their chance of survival. If the hemoglobin concentration is plotted against the chance of survival, a sigmoid curve is obtained. Probit analysis can be applied and the results of treatment can then be summarized in terms of the severity of the cases treated. For example, in the present series the cord hemoglobin concentration corresponding to a 50 per cent chance of survival was 8.09 Gm./100 ml. 2. Application of probit analysis makes it possible to compare results obtained in different centers, for due allowance is made for any difference in severity in the cases included in the different series. 3. In the present series, despite uniform treatment (exchange transfusion), over-all mortality fell from 37 percent in 1947 and 1948 to 3 per cent in 1950. It is shown that this can be entirely explained by a decrease in the number of severely affected infants. 4. Predictions of survival based on the cord hemoglobin concentration and cord bilirubin concentration combined are not significantly better than predictions based on cord hemoglobin concentration alone. 5. Infants with positive direct Coombs tests whose cord hemoglobin concentrations exceed 15.5 Gm./100 ml. have some risk (approximately 1 in 12) of developing kernicterus, if untreated.

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

scholarly journals Severe ABO hemolytic disease of fetus and newborn requiring blood exchange transfusion

2018 ◽  
Vol 12 (2) ◽  
pp. 176 ◽  
Author(s):  
Ashish Jain ◽  
Sheetal Malhotra ◽  
Neelam Marwaha ◽  
Praveen Kumar ◽  
RattiRam Sharma
Keyword(s):  
Exchange Transfusion ◽  
Hemolytic Disease ◽  
Blood Exchange ◽  
Blood Exchange Transfusion ◽  
Abo Hemolytic Disease

The Effect of Phototherapy on the Hyperbilirubinemia of Rhesus Incompatibility

PEDIATRICS ◽  
1974 ◽  
Vol 54 (4) ◽  
pp. 417-422
Author(s):  
Andrew T. Shennan
Keyword(s):  
Cord Blood ◽  
Retrospective Analysis ◽  
Exchange Transfusion ◽  
Treated Group ◽  
Hemolytic Disease ◽  
Bilirubin Concentration ◽  
Indirect Bilirubin ◽  
Rhesus Incompatibility ◽  
The Mean ◽  
Methods Of Treatment

A retrospective analysis was made of the case records of 141 infants with jaundice due to rhesus incompatibility born in one unit over a six-year period during which phototherapy was introduced, in order to ascertain the effect of this form of treatment on the serum indirect bilirubin concentration. The infants were allocated to four groups of severity based on cord blood findings and the curve of bilirubin concentration drawn over the first 48 hours of life. Infants born before the advent of phototherapy acted as controls for those treated. There was a highly significant reduction in the level of indirect bilirubin reached in the mildest group not requiring exchange transfusion at birth, the mean bilirubin at 48 hours being lowered by 3.5 mg/100 ml in the treated group. Phototherapy exerted a lesser effect on the jaundice of more severely affected groups but still significantly reduced the rate of rise and the number of second and subsequent exchange transfusions. It is concluded that phototherapy is a valuable addition to the current methods of treatment of hemolytic disease due to rhesus incompatibility.

A COMPARISON OF THE EFFECTS OF WHOLE BLOOD AND SEDIMENTED ERYTHROCYTES IN EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1958 ◽  
Vol 21 (1) ◽  
pp. 81-90
Author(s):  
Thomas R. C. Sisson ◽  
Lorraine E. Whalen ◽  
Amalia Telek
Keyword(s):  
Whole Blood ◽  
Relative Efficiency ◽  
Exchange Transfusion ◽  
The Other ◽  
Hemolytic Disease ◽  
Total Blood ◽  
Significant Difference ◽  
Rh Incompatibility ◽  
Hemoglobin Mass ◽  
Blood Volumes

The relative efficiency of whole blood compared with sedimented erythrocytes in exchange transfusion was studied in regard to the correction of anemia. Two groups of infants with hemolytic disease of the newborn due to maternal-fetal Rh incompatibility were transfused with one or the other type of blood. Determinations of concentration of hemoglobin; packed cell volume; plasma, erythrocyte, and total blood volumes; and total circulating hemoglobin mass were made and compared. It was concluded that the use of sedimented erythrocytes does not lead to a deficit of erythrocyte volume and circulating hemoglobin mass as does the use of whole blood. Analysis of data from 47 infants, 23 of whom received whole blood, and 24 of whom received sedimented erythrocytes, indicates that a significant difference in concentration of bilirubin occurs. The increase in concentration of bilirubin subsequent to exchange transfusion was lower and less rapid in most infants of the group receiving sedimented erythrocytes. For these reasons the use of sedimented rather than whole blood is suggested in exchange transfusion for hemolytic disease of the newborn.

scholarly journals Effect of iron and zinc supplementation in the treatment of malaria in children

2007 ◽  
Vol 47 (6) ◽  
pp. 256
Author(s):  
Danny Dasraf ◽  
Bugis Mardina Lubis ◽  
Bidasari Lubis ◽  
Nelly Rosdiana ◽  
Munar Lubis ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Iron Supplementation ◽  
Zinc Supplementation ◽  
Reticulocyte Count ◽  
Hemoglobin Concentration ◽  
Plasmodium Falciparum Malaria ◽  
Significant Difference ◽  
Iron And Zinc ◽  
Reticulocyte Production

Background Iron and zinc administration for children withmalaria in endemic area were known to decrease parasitemia butdata on their effectiveness when given together to increasereticulocytes as erythropoiesis parameter and hemoglobin isinsufficient.Objective To determine the effect of zinc to increase ironabsorption in the treatment of Plasmodium falciparum malaria inchildren.Methods Children with positive Plasmodium falciparum on theirblood smear (n=86) examination were randomly assigned to dailysupplementation of iron 6 mg per kg body weight per day plusplacebo or iron plus zinc 10 mg per day for 30 days. Venous bloodspecimens were collected at the start and at the end of the study.Results Sixty-nine children completed the supplementations andhad both baseline and follow-up blood specimen study. After 30-day supplementation, the iron plus placebo and iron plus zincgroups showed significant difference on hemoglobin concentration(0.58 and 0.09 g/dl; P<0.05). There was no significant differencein reticulocyte production index and reticulocyte count beforeand after intervention in both groups. There was only significantdifference in red blood cells concentration after supplementationof iron plus placebo and iron plus zinc (4.7 in 4.5 million/μl;P<0.05).Conclusions Iron supplementation with or without zinc showssignificant increase of hemoglobin concentration. It is slightlyhigher in iron plus placebo group.

scholarly journals Intravenous immunoglobulin G in the treatment of ABO hemolytic disease of the newborn during the early neonatal period at a tertiary academic hospital: a retrospective study

2021 ◽  
Author(s):  
Jiarong Pan ◽  
Canyang Zhan ◽  
Tianming Yuan ◽  
Xiangxiang Chen ◽  
Yanyan Ni ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Intravenous Immunoglobulin ◽  
Immunoglobulin G ◽  
Neonatal Period ◽  
Hemolytic Disease ◽  
Neurological Sequelae ◽  
Early Neonatal Period ◽  
Significant Difference ◽  
Intravenous Immunoglobulin G ◽  
Abo Hemolytic Disease

Abstract Objective To evaluate the efficacy and safety of intravenous immunoglobulin G (IVIG) in infants with ABO hemolytic disease of the newborn (HDN). Methods Infants with moderate-to-severe ABO HDN during early neonatal period (<7 days) at our hospital in 2017 were included in this retrospective study. Patients treated with IVIG and phototherapy were classified as the IVIG group, and those who only received phototherapy were classified as the phototherapy only group. Results Forty-six patients were classified into the IVIG group and 68 other patients were classified into the phototherapy only group. There was no significant difference in duration of phototherapy, hospitalization periods, needs for exchange transfusion, transfusions, and incidence of bilirubin-induced neurological sequelae between these two groups (P = 0.20, 0.27, 0.65, 0.47, 0.78, respectively). Conclusion It seems unnecessary to expose neonates to IVIG in moderate-to-severe ABO HDN when the available data show no appreciable benefits.

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