Effect of High-dose Intrevenous Immune Globulin in the Treatment of Neonatal Immune Hemolytic Jaundice Unresponsive to Phototherapy.
- Author:
Sang Lak LEE
;
Yoon Jung CHO
;
Cheon Soo KIM
- Publication Type:Original Article
- Keywords:
Immune hemolytic jaundice;
Newborn;
High-dose intravenous immune globulin
- MeSH:
Bilirubin;
Blood Group Incompatibility;
Erythrocytes;
Humans;
Hyperbilirubinemia;
Immunoglobulins, Intravenous;
Infant, Newborn;
Jaundice*;
Mononuclear Phagocyte System;
Phototherapy*;
Receptors, Fc;
Reticulocyte Count
- From:Korean Journal of Perinatology
1999;10(2):176-182
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Immune hemolytic jaundice is caused by the destruction of antibody-sensitized erythrocytes and is associated with antibody-dependent cellular cytotoxic effects mediated by Fc receptor-bearing cells of the reticuloendothelial system. Intravenous immune globulin(IVIG) may have exerted its effect through Fc receptor blockade. We studied the effect of high-dose intravenous immune globulin(HDIVIG) in neonatal hemolytic jaundice unresponsive to phototherapy. METHODS: We selected only those with Coombs test(+) immune hemolytic jaundice who had admittcd at the NICU of the Dcpartment of Pediatzics of Dongsan Medical Center, Keimyung University between January 1995 and December 1998. They were unresponsive to phototherapy. Ten newborn infants(9 ABO incomplatibilities, l minor group incompatabillity due to anti-E) received HDIVIG therapy combined with phototherapy. IVIG was given as a dose of lg/kg for 6 hours, and serial hemoglobin, reticulocyte count, and bilirubin levels were evaluated. If the serum bilirubin level went up and reached the level above 22mg/dl, we conducted exchange transfusion for the patient. RESULTS: HDIVIG induced a significant decrease of serum billirubin levels in 8(80%, group I, HDIVIG responsive poup) of 10 cases and only 2 cases(group II, HDIVIG unreponsive group) required exchange tnnsfusions. No side effect was observed after HDIVIG therapy. CONCLUSION: We suggest HDIVIG may be effective in the treatment of phototherapy-resistant hyperbilirubinemia due to blood group incompatibility. More studies are needed to confirm the optimal dosage and therapeutic indication of HDIVIG in the therapy of neonatal immune hemolytic jaundice.
