Experience of High-Dose Intravenous Immune Globulin Therapy for Neonatal Immune Hemolytic Jaundice due to ABO Incompatibility.
- Author:
Yun Sook JOUNG
1
;
Moon Yung CHOI
;
Bo Young YOON
;
Sun Han BAE
;
Hyae Sun YOON
;
Dong Woo SON
Author Information
1. Department of Pediatrics, Eulji Medical Center, Nowon Hospital, School of Medicine, Eulji University.
- Publication Type:Original Article
- Keywords:
Neonatal immune hemolytic jaundice;
ABO blood group incompatibility;
Intravenous immune globulin
- MeSH:
Bilirubin;
Blood Group Incompatibility;
Coombs Test;
Humans;
Hyperbilirubinemia;
Immunoglobulins, Intravenous*;
Infant;
Jaundice*;
Kernicterus;
Nurseries;
Phototherapy
- From:Journal of the Korean Society of Neonatology
2001;8(2):228-235
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Neonatal immune hemolytic jaundice due to blood group incompatibility is important to treat properly because of an early rise and a high peak of serum bilirubin level and a risk of kernicterus. The conventional therapeutic modalities for neonatal immune hemolytic jaundice due to blood group incompatibility are phototherapy and exchange transfusion. We evaluated the effect of intravenous immune globulin (IVIG) therapy on hyperbilirubinemia due to ABO incompatibility. METHODS: This study included 6 infants with hyperbilirubinemia due to ABO incompatibility who were admitted to the nursery of Eulji Medical Center, Nowon Hospital, from January 2000 to February 2001. All 6 infants had a positive direct Coombs test. Their serum bilirubin levels were above 12 mg/dl within 24hours of age and above 20 mg/dl after 24hours of age. They were treated with intensive phototherapy and IVIG. RESULTS: We classified the effective group when a decline in serum bilirubin level was more than 2 mg/dl in 3-4 hours after IVIG therapy, and the ineffective group when there was a decline in serum bilirubin level less than 2 mg/dl, a re-rise after the initial response to IVIG, or a decline after the combined therapy with intensive phototherapy and IVIG equal or less than that after intensive phototherapy alone. In the effective group (n=2), the average decline in serum bilirebin level was 4.1 mg/dl in 3-4 hours and 8.1 mg/dl in 12-16 hours after IVIG therapy, while in the ineffective group (n=4), the average decline was 1.9 mg/dl and 2.7 mg/dl, respectively. Five among 6 infants were treated with IVIG therapy and 1 infant was treated with exchange transfusion. No serious side effect was detected during and after IVIG therapy. CONCLUSION: We demonstrated the effectiveness of IVIG therapy in 2 infants out of six who were treated with intensive phototherapy and IVIG for hyperbilirubinemia due to ABO incompatibility. IVIG therapy could be considered if hyperbilirubinemia due to ABO incompatibility does not respond to intensive phototherapy alone. Further prospective and randomized studies would be needed.
