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Intravenous immunoglobulin and neonatal jaundice

Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
Carolien Zwiers, Mirjam Ea Scheffer-Rath, Enrico Lopriore, Masja de Haas, Helen G Liley
BACKGROUND: Exchange transfusion and phototherapy have traditionally been used to treat jaundice and avoid the associated neurological complications. Because of the risks and burdens of exchange transfusion, intravenous immunoglobulin (IVIg) has been suggested as an alternative therapy for alloimmune hemolytic disease of the newborn (HDN) to reduce the need for exchange transfusion. OBJECTIVES: To assess the effect and complications of IVIg in newborn infants with alloimmune HDN on the need for and number of exchange transfusions...
March 18, 2018: Cochrane Database of Systematic Reviews
Omer Erdeve, Emel Okulu, Ozgur Olukman, Dilek Ulubas, Gokhan Buyukkale, Fatma Narter, Gaffari Tunc, Begum Atasay, Nazli Dilay Gultekin, Saadet Arsan, Esin Koc
BACKGROUND: Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. METHODS: A multicenter prospective study was conducted on otherwise healthy newborns born at ≥35 weeks of gestation and hospitalized for only NNJ in 50 collaborator neonatal intensive care units across Turkey over a 1-year period...
2018: PloS One
Lani Lieberman, Jordan Spradbrow, Amy Keir, Michael Dunn, Yulia Lin, Jeannie Callum
BACKGROUND: Intravenous immunoglobulin (IVIG) is used to treat a variety of diseases in the neonatal intensive care unit (NICU). Although audits have reported on the spectrum of IVIG use in adults, the indications and utilization in neonates has not been investigated. The objectives of this study were to describe the usage pattern of and indications for IVIG in a tertiary care NICU. STUDY DESIGN AND METHODS: A retrospective chart review was performed of all neonates who received IVIG in the NICU from January 2003 to December 2013...
November 2016: Transfusion
Basak Yildiz Atikan, Ozge Altun Koroglu, Mehmet Yalaz, Orkan Ergun, Zafer Dokumcu, Basak Doganavsargil, Mete Akisu, Nilgun Kultursay
Neonatal appendicitis is a rare clinical condition that may cause high morbidity and mortality if diagnosis is delayed. There is usually an underlying disease; it can also be a localized form of necrotizing enterocolitis. Here, we present a term neonate who was treated with intravenous immunoglobulin because of severe isoimmune hemolytic jaundice. The patient developed abdominal symptoms within 10 hours of therapy, was diagnosed with acute perforated appendicitis and completely recovered after surgery.
April 2015: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
A Cortey, M Elzaabi, T Waegemans, B Roch, Y Aujard
OBJECTIVES: ABO fetomaternal red blood cell incompatibility (ABO FMI) induces an immune hemolysis after fetal transfer of hemolyzing maternal anti-A or anti-B. ABO hemolytic disease (ABO HD) remains the most frequent cause of severe and early jaundice in newborns. High levels of unconjugated hyperbilirubinemia may induce acute and chronic neurological complications. Severe hyperbilirubinemia can be prevented by first-line phototherapy (PT) treatment, but exchange transfusion (ET) is required if treatment is not effective, even if ET is linked with high hemodynamic, infectious, gastrointestinal, and/or biological morbidity...
September 2014: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Sinem Akgül, Ayşe Korkmaz, Sule Yiğit, Murat Yurdakök
Newborn infants with maternal-fetal ABO incompatibility are at a greater risk for developing subsequent significant hyperbilirubinemia, and therefore, prediction of probable risk factors, such as the degree of hemolysis, gains importance. In this study, we aimed to evaluate the effect of fetal-neonatal blood group on the severity of hemolysis and jaundice due to maternal-fetal ABO incompatibility. In a retrospective analysis of 166 cases with ABO hemolytic disease of the newborn, risk factors for the severity of jaundice were compared in infants with blood group A or B...
September 2013: Turkish Journal of Pediatrics
Hamilton P Schwartz, Beth E Haberman, Richard M Ruddy
It is estimated that about two thirds of newborns will appear clinically jaundiced during their first weeks of life. As newborns and their mothers spend fewer days in the hospital after birth, the number of infants readmitted yearly in the United States for neonatal jaundice over the last 10 years has increased by 160%. A portion of these infants present to the emergency department, requiring a careful history and physical examination assessing them for the risk factors associated with pathologic bilirubin levels...
September 2011: Pediatric Emergency Care
Gamze Demirel, Melek Akar, Istemi Han Celik, Omer Erdeve, Nurdan Uras, Serife Suna Oguz, Ugur Dilmen
Intravenous immunoglobulin (IVIG) has been found to decrease hemolysis in neonatal jaundice due to blood group incompatibility, but a consensus on its usage has not been reached. We conducted a study to compare single versus multiple dose of IVIG in combination with light emitting diode (LED) phototherapy in patients with neonatal jaundice secondary to ABO blood incompatibility, and compared the efficacy of these treatments with that in a group of patients who received LED phototherapy solely. Thirty-nine term neonates with ABO blood group incompatibility were enrolled in the study...
June 2011: International Journal of Hematology
Alexander Dillon, Tejasvi Chaudhari, Phillip Crispin, Bruce Shadbolt, Alison Kent
AIM: To determine the impact of Rhesus (Rh) D prophylaxis on positive direct antiglobulin test (DAT) results and ability of a DAT grade to predict an infant's need for phototherapy. METHODS: Laboratory and infant medical records were reviewed for DAT status, DAT grade, interventions for hyperbilirubinemia including phototherapy, blood transfusion, exchange transfusion and intravenous immunoglobulin. Two epochs of DAT results were reviewed, the first in the era prior to Rh D prophylaxis, the second after introduction of standardised Rh D prophylaxis for Rh negative women...
January 2011: Journal of Paediatrics and Child Health
Deepak Louis, Sapna Oberoi, Venkataseshan Sundaram, Amita Trehan
Rh isoimmunization manifesting as isolated early onset neonatal anemia has not been reported. We describe the presentation of 3 infants who manifested with isolated early severe anemia. All the infants presented early (3 to 7 d of age) with severe pallor. None had clinically significant jaundice. Evidence for hemolysis was present in all and their direct antiglobulin test was positive. To reduce the hemolysis, immunoglobulin was administered after which their hemoglobin improved. This report highlights the possibility of early onset anemia without significant jaundice as the sole manifestation of Rh isoimmunization and the possible beneficial role of immunoglobulin in them...
August 2010: Journal of Pediatric Hematology/oncology
Atul Malhotra, Elizabeth Carse
BACKGROUND: Haemolytic jaundice is an important entity in neonatal clinical practice. Because of the decrease in rhesus isoimmunisation since the advent of anti-D immunoglobulin and improved antenatal management strategies, its management in the neonatal period has become less intensive and exchange transfusions rarely performed. AIM: We planned to review the practice of Australasian perinatal units in light of recent advances and recommendations. METHODS: An electronic survey was sent to the directors of all 25 tertiary-level perinatal units across Australasia...
May 2010: Journal of Paediatrics and Child Health
Xiang-yu Gao, Huan Huang, Li-da Li
OBJECTIVE: To analyze and summarize clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M. METHODS: Data of one case of HDN due to anti-M and the reports of 21 cases seen in the past 20 years at the home country were reviewed and analyzed. RESULTS: There was an increasing number of reports of cases with HDN due to anti-M. Among the 22 cases, four were the first fetus. Of 18 infants, ten were male, and eight were female...
September 2009: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Jillian Roberts, Mark A Toney
No abstract text is available yet for this article.
September 2007: Advance for Nurse Practitioners
Khaled Boudhraa, Sihem Mammou, Nadia Ben Salah, Med Faouzi Gara
Although very rare, red-cell immunization is a main factor of hemolytic fetal anemia and severe neonatal jaundice. We emphasize on the prevention of immunization in different situations of feto maternal bleeding by early intravenous injection of 200 at 300 IU or more depending on the term of pregnancy, the circumstances and results of the Kleihauer's test. Prophylaxis corresponds a systematic intramuscular injection of 300 IU immunoglobulin (Natead ) at 28 WA, is performed in many countries. This measure implies information and rigor from Perinatal's professional...
April 2009: La Tunisie Médicale
N M Allen, F Mohammad, A Foran, D Corcoran, T Clarke
Since the 1990s, there has been a re-emergence of cases of severe hyperbilirubinaemia and kernicterus. The current UK incidence of bilirubin encephalopathy is 0.9/100,000 with a higher reported incidence in some countries. Three otherwise healthy newborn infants, who presented with severe hyperbilirubinaemia, including one who developed kernicterus, are reported here. Some of the current challenges in newborn jaundice surveillance are highlighted.
July 2009: Irish Medical Journal
F Monpoux, C Dageville, A-M Maillotte, S De Smet, F Casagrande, P Boutté
Neonatal jaundice resulting from immunological hemolysis is not uncommon. While it is possible to prevent a large number of Rh-isoimmune hemolytic diseases by administration of specific anti-D immunoglobulins to the mother, the prevention of incompatibility in the ABO groups is not feasible. In spite of advances made in the use of phototherapy, and in order to avoid kernicterus, the treatment of these jaundices can require one or several exchange transfusions (ET), a therapy which is not devoid of risk. For some time now, the data concerning the efficiency of high-dose intravenous immunoglobulin therapy (HDIIT) in the treatment of these jaundices have been increasing...
September 2009: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Thor Willy Ruud Hansen, Lutz Nietsch, Elisabeth Norman, Jesper Vandborg Bjerre, Jean-Michel Hascoet, Khalaf Mreihil, Finn Ebbesen
AIM: To show the potential for reversing acute intermediate to advanced phase bilirubin encephalopathy. METHODS: Case studies. RESULTS: Six extremely jaundiced infants had symptoms of intermediate to advanced phase acute bilirubin encephalopathy. The infants were treated aggressively. Two patients had brain magnetic resonance imaging showing increased signals in the globus pallidus. On follow-up, all infants are neurologically normal. CONCLUSIONS: Intermediate-to-advanced stage acute bilirubin encephalopathy may occasionally be reversible...
October 2009: Acta Paediatrica
Robin L Watson
Hyperbilirubinemia is the most common condition requiring evaluation and treatment in newborns. The clinical manifestation of hyperbilirubinemia-jaundice-occurs in 60% of normal newborns and nearly all preterm infants. Compared with conditions that require advanced pharmacologic and technologic treatment strategies, hyperbilirubinemia seems to be overshadowed and may lose the attention it deserves as a condition that has potentially devastating effects. Nurses must be vigilant when caring for babies with "just jaundice" by monitoring bilirubin levels, identifying infants at risk for developing severe hyperbilirubinemia, and implementing prescribed treatment effectively when indicated...
March 2009: Critical Care Nursing Clinics of North America
Satish Mishra, Ramesh Agarwal, Ashok K Deorari, Vinod K Paul
Hyperbilirubinemia is the commonest morbidity in the neonatal period and 5-10% of all newborns require intervention for pathological jaundice. Neonates on exclusive breast-feeding have a different pattern and degree of jaundice as compared to artificially fed babies. Latest guidelines from the American Academy of Pediatrics (AAP) for management of jaundice in a normal term newborn have been included in the protocol. Separate guidelines have been provided for the management of jaundice in sick term babies, preterm and low birth weight babies, for hemolytic jaundice and prolonged hyperbilirubinemia...
February 2008: Indian Journal of Pediatrics
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