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IVIG in immunhemolytic disease of newborn


thabit

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We frequently use IVIG in Hemolytic causes of Neonatal Jaundice with very good results.

The moment we have a baby with jaundice with DCT result positice and the baby is showing a rising trend of bilirubin we do not hesitate to give IVIG.

We give 1 gm/kg iv over 4 hours as infusion.

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Dear Colleagues,

We have recently published 2 cases of NEC associated with the use of IVIG for hemolytic disease of the newborn.The abstract of the reference follows below.

Best regards from New York!

Sergio

CLINICAL OBSERVATION

Necrotizing enterocolitis following the use of intravenous immunoglobulin for haemolytic disease of the newborn

Mariel Navarro 1 , Sergio Negre 1 , María Luisa Matoses 1 , Sergio G Golombek 2 , Maximo Vento 1

1.Division of Neonatology, University Hospital La Fe, Valencia, Spain 2.Regional Neonatal Center,Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

Correspondence

Máximo Vento, Ph.D., M.D., Neonatal Research Unit, Division of Neonatology, University Hospital La Fe, Avenida de Campanar, 21, E46009 Valencia, Spain. Tel: +34-963862791 | Fax: +34-961973408 | Email: maximo.vento@uv.es

Copyright Journal Compilation © 2009 Foundation Acta Pædiatrica

KEYWORDS

Haemolysis • Hyperbilirubinaemia • Immunoglobulin • Isoimmune • Necrotizing enterocolitis

ABSTRACT

Aim: To describe a series of patients who received intravenous immunoglobulin (IVIg) for the treatment of neonatal hyperbilirubinaemia and developed necrotizing enterocolitis (NEC) shortly thereafter.

Population and Results: We describe three healthy breastfed newly born infants with isoimmunization-derived hyperbilirubinaemia refractory to phototherapy who were treated with IVIg. Shortly after the perfusion finished they developed clinical and radiological signs compatible with NEC and needed antibiotic therapy, prolonged parenteral nutrition and even surgery in one case. Other conditions such as septicaemia or coagulopathy were ruled out. Microscopic examination of the resected intestine revealed the presence of disseminated thrombi obstructing multiple minor vessels of the mesenteric circulation.

Conclusion: IVIg in the newborn period should be cautiously employed and always administered under strict medical control.

--------------------------------------------------------------------------------

Received

1 January 2009; revised 17 February 2009; accepted 23 February 2009.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1651-2227.2009.01279.x About DOI

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