Abstract
Intravenous Immunoglobulin G (IVIG) therapy has been used as a component of the treatment of hemolytic disease of the newborn. There is still no consensus on its use in ABO hemolytic disease of the newborn routinely. The aim of this study is to determine whether administration of IVIG to newborns with ABO incompatibility is necessary. One hundred and seventeen patients with ABO hemolytic disease and positive Coombs test were enrolled into the study. The subjects were healthy except jaundice. Infants were divided into two groups: Group I (n = 71) received one dose of IVIG (1 g/kg) and LED phototherapy whereas Group II (n = 46) received only LED phototherapy. One patient received erythrocyte transfusion in Group I, no exchange transfusion was performed in both groups. Mean duration of phototherapy was 3.1 ± 1.3 days in Group I and 2.27 ± 0.7 days in Group II (p < 0.05). Mean duration of hospital stay was 5.34 ± 2.2 days in Group I and 3.53 ± 1.3 days in Group II (p < 0.05). Mean duration of phototherapy was 4.0 ± 1.5 days and 2.73 ± 1.1 days in double and single doses of IVIG respectively, and this was statistically significant (p < 0.05). IVIG therapy didn’t decrease neither phototherapy nor hospitalization duration in infants with ABO hemolytic disease. Meticulus follow-up of infants with ABO hemolytic disease and LED phototherapy decreases morbidity. IVIG failed to show preventing hemolysis in ABO hemolytic disease.
Similar content being viewed by others
References
Zipursky A, Bowman JM (1993) Isoimmune hemolytic disease. In: Nathan OG, Oski FA (eds) Haematology of infancy and childhood, 4th edn. WB Saunders, Philadelphia, pp 66–69
Usha KK, Sulochana PV (1998) Detection of high risk pregnancies with relation to ABO hemolytic disease of the newborn. Indian J Pediatr 65:863–865
Maisels MJ, Kring E (1992) Risk of sepsis in newborns with severe hyperbilirubinemia. Pediatrics 90:741–743
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia (2004) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 114:297–316
Urbaniak SJ (1979) ADCC (K cell) lysis of human erythrocytes sensitized with Rhesus alloantibodies. II. Investigation into mechanism of lysis. Br J Haematol 42:315–328
Glader B, Allen G (2005) Neonatal hemolysis. In: Alarcon P, Werner E (eds) Neonatal hematology, 1st edn. Cambridge University Press, Cambridge, p 133
Orzalesi M, Gloria F, Lucarelli P, Bottini E (1973) ABO system incompatibility:relationship between direct Coombs’ test positivity and neonatal jaundice. Pediatrics 51:288–289
Yaseen H, Khalaf M, Rashid N, Darwich M (2005) Does prophylactic phototherapy prevent hyperbilirubinemia in neonates with ABO incompatibility and positive coombs test? J Perinatol 25:590–594
Ouwehand WH, Smith G, Ranasinghe E (2000) Management of severe alloimmune thrombocytopenia in the newborn. Arch Dis Child Fetal Neonatal Ed 82:F173–F175
Ohlsson A, Lacy JB (2010) Intravenous immunoglobulin for suspected or subsequently proven infection in neonates (Cochrane Review). The Cochrane Library, Oxford (Updated Software, issue 3)
Gottstein R, Cooke RWI (2003) Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed 88:F6–F10
Alpay F, Sarıcı SU, Okutan V, Erdem G, Ozcan O, Gökcay E (1999) High-dose intravenous immunglobulin therapy in neonatal immune haemolytic jaundice. Acta Paediatr 88:216–219
Girish G, Chawla D, Agarwal R, Paul VK, Deorari AK (2008) Efficacy of two dose regimes of intravenous immunoglobulin in Rh hemolytic disease of newborn-a randomised controlled trial. Indian Pediatr 45:653–659
Elalfy MS, Elbarbary NS, Abaza HW (2011) Early intravenous immunoglobulin (two-dose regimen) in the management of severe Rh hemolytic disease of newborn-a prospective randomisd controlled trial. Eur J Pediatr 170:461–467
Smits-Wintjens VE, Walther FJ, Rath ME, Lindenburg IT, te Pas AB, Kramer CM et al (2011) Intravenous immunoglobulin in neonates with rhesus hemolytic disease: a randomised controlled trial. Pediatrics 127:680–686
Migdad AM, Abdelbasit OB, Shaheed MM, Seidahmed MZ, Abomelha AM, Arcala OP (2004) Intravenous immunoglobulin G (IVIG) therapy for significant hyperbilirubinemia in ABO hemolytic disease of the newborn. J Matern Fetal Neonatal Med 16:163–166
Demirel G, Akar M, Celik IH, Erdeve OH, Uras N, Oguz SS et al (2011) Single versus multiple dose intravenous immunoglobulin in combination with LED phototherapy in the treatment of ABO hemolytic disease in neonates. Int J Hematol 93:700–703
Vreman HJ, Wong RJ, Stevenson DK, Route RK, Reader SD, Fejer MM et al (1998) Light-emitting diodes: a novel light source for phototherapy. Pediatr Res 44:804–809
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Beken, S., Hirfanoglu, I., Turkyilmaz, C. et al. Intravenous Immunoglobulin G Treatment in ABO Hemolytic Disease of the Newborn, is it Myth or Real?. Indian J Hematol Blood Transfus 30, 12–15 (2014). https://doi.org/10.1007/s12288-012-0186-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-012-0186-3