Research Article


DOI :10.26650/jchild.2022.1130184   IUP :10.26650/jchild.2022.1130184    Full Text (PDF)

THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG)

Beril YaşaSait İlker UsluŞeyma MemurDilek Yavuzcan ÖztürkOnur BağcıHalime Sema Can BükerMeliha AksoyMüge PayaslıCansu MulukNilay GündoğduMerih Çetinkaya

Objective: The ABO hemolytic disease is the most common alloimmune hemolytic disease in the neonatal period. The conventional treatment strategies for indirect hyperbilirubinemia caused by hemolysis are phototherapy and exchange transfusion. IVIG can also be used to prevent hemolysis. This study aimed to evaluate the efficacy of IVIG use in infants with ABO hemolytic disease. Materials and Method: Infants with gestational age >37 weeks, with a positive direct Coombs test, and having phototherapy for indirect hyperbilirubinemia were included in the study (n=192). Enzyme deficiency (G6PD), polycythemia, visceral hemorrhage, pathological weight loss and septicemia were the exclusion criteria. The newborn infants were reviewed retrospectively in two groups as the only phototherapy group and the phototherapy and IVIG group. Results: The mean gestational age and birth weight of the infants were similar between groups. The hospital stay and phototherapy duration were significantly longer and hemoglobin decrease from birth to discharge was significantly higher in the phototherapy and IVIG group. There was no difference found between the infants who received one dose or recurrent doses of IVIG in terms of highest bilirubin level and total phototherapy duration. Conclusion: This study showed that IVIG use in ABO hemolytic disease of newborns in addition to phototherapy neither prevents hemolysis nor decreases phototherapy duration and hospital stay. Recurrent doses of IVIG treatment have no clinical benefit over single dose IVIG treatment. The first choice of treatment should be an effective phototherapy in indirect hyperbilirubinemia due to ABO hemolytic disease. Further larger prospective studies are needed to assess the IVIG use in ABO hemolytic disease.

DOI :10.26650/jchild.2022.1130184   IUP :10.26650/jchild.2022.1130184    Full Text (PDF)

ABO Hemolitik Hastalığı Olan Yenidoğan Bebeklerde İntravenöz İmmunglobulin G (IVIG) Kullanımının Klinik Sonuçlar Üzerine Etkisi

Beril YaşaSait İlker UsluŞeyma MemurDilek Yavuzcan ÖztürkOnur BağcıHalime Sema Can BükerMeliha AksoyMüge PayaslıCansu MulukNilay GündoğduMerih Çetinkaya

Amaç: ABO hemolitik hastalık yenidoğan döneminde en sık görülen alloimmün hemolitik hastalıktır. Hemolitik hastalıklara bağlı gelişen sarılık varlığında geleneksel tedavi yöntemleri fototerapi ve kan değişimi olmakla birlikte hemolizin önlenmesi için intravenöz immunglobulin G (IVIG) tedavisi de kullanılmaktadır. Bu çalışma ile ABO hemolitik hastalığı olan yenidoğan bebeklerde IVIG kullanımının klinik sonuçalar üzerine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Gebelik yaşı 37 hafta ve üzerinde, direkt coombs testi pozitif olan, indirekt hiperbilirubinemi nedeniyle fototerapi tedavisi başlanan 192 bebek çalışmaya dahil edildi. Enzim eksikliği (G6PD), polisitemi, viseral kanama, sefal hematom, patolojik tartı kaybı, metabolik hastalık ve sepsis şüphesi olan bebekler çalışmaya alınmadı. Bebekler sadece fototerapi alan ve fototerapi tedavisine ek IVIG tedavisi alan bebekler olarak iki grupta retrospektif olarak incelendi. Bulgular: Bebeklerin ortalama gebelik yaşları ve doğum tartıları benzerdi. IVIG uygulanan bebeklerde fototerapi ve hastanede yatış süreleri anlamlı olarak uzun, doğumdaki hemoglobin ve hematokrit değerlerine göre taburculuk değerlerinde gözlenen düşme (Δ Hemoglobin ve Δ Hematokrit) IVIG uygulanmayan gruba göre anlamlı olarak yüksek bulundu. Hemoliz bulguları devam ettiği için tekrar doz IVIG tedavisi alan bebeklerde ise en yüksek bilirubin düzeyleri ve toplam fototerapi süresi açısından tek doz IVIG tedavisi alan gruba göre anlamlı fark saptanmadı. Tartışma: Bu çalışma ile yenidoğanların ABO hemolitik hastalığında fototerapi tedavisine ek olarak IVIG kullanımının hemolizi önlemediği, fototerapi ve hastanede yatış süresini kısaltmadığı gösterilmiş, tekrarlanan dozlarda IVIG uygulamasının klinik etki olarak tek doz IVIG uygulamasından üstün olmadığı saptanmıştır. ABO hemolitik hastalığa bağlı gelişen indirekt hiperbilirubinemi tedavisinde halen ilk tercih etkin uygulanan fototerapi olmalıdır. ABO hemolitik hastalıkta IVIG kullanımını önermek için geniş hasta sayılı prospektif çalışmalara ihtiyaç vardır.


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APA

Yaşa, B., Uslu, S., Memur, Ş., Öztürk, D., Bağcı, O., Can Büker, H.S., Aksoy, M., Payaslı, M., Muluk, C., Gündoğdu, N., & Çetinkaya, M. (2022). THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG). Journal of Child, 22(3), 172-177. https://doi.org/10.26650/jchild.2022.1130184


AMA

Yaşa B, Uslu S, Memur Ş, Öztürk D, Bağcı O, Can Büker H S, Aksoy M, Payaslı M, Muluk C, Gündoğdu N, Çetinkaya M. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG). Journal of Child. 2022;22(3):172-177. https://doi.org/10.26650/jchild.2022.1130184


ABNT

Yaşa, B.; Uslu, S.; Memur, Ş.; Öztürk, D.; Bağcı, O.; Can Büker, H.S.; Aksoy, M.; Payaslı, M.; Muluk, C.; Gündoğdu, N.; Çetinkaya, M. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG). Journal of Child, [Publisher Location], v. 22, n. 3, p. 172-177, 2022.


Chicago: Author-Date Style

Yaşa, Beril, and Sait İlker Uslu and Şeyma Memur and Dilek Yavuzcan Öztürk and Onur Bağcı and Halime Sema Can Büker and Meliha Aksoy and Müge Payaslı and Cansu Muluk and Nilay Gündoğdu and Merih Çetinkaya. 2022. “THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG).” Journal of Child 22, no. 3: 172-177. https://doi.org/10.26650/jchild.2022.1130184


Chicago: Humanities Style

Yaşa, Beril, and Sait İlker Uslu and Şeyma Memur and Dilek Yavuzcan Öztürk and Onur Bağcı and Halime Sema Can Büker and Meliha Aksoy and Müge Payaslı and Cansu Muluk and Nilay Gündoğdu and Merih Çetinkaya. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG).” Journal of Child 22, no. 3 (Mar. 2024): 172-177. https://doi.org/10.26650/jchild.2022.1130184


Harvard: Australian Style

Yaşa, B & Uslu, S & Memur, Ş & Öztürk, D & Bağcı, O & Can Büker, HS & Aksoy, M & Payaslı, M & Muluk, C & Gündoğdu, N & Çetinkaya, M 2022, 'THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG)', Journal of Child, vol. 22, no. 3, pp. 172-177, viewed 29 Mar. 2024, https://doi.org/10.26650/jchild.2022.1130184


Harvard: Author-Date Style

Yaşa, B. and Uslu, S. and Memur, Ş. and Öztürk, D. and Bağcı, O. and Can Büker, H.S. and Aksoy, M. and Payaslı, M. and Muluk, C. and Gündoğdu, N. and Çetinkaya, M. (2022) ‘THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG)’, Journal of Child, 22(3), pp. 172-177. https://doi.org/10.26650/jchild.2022.1130184 (29 Mar. 2024).


MLA

Yaşa, Beril, and Sait İlker Uslu and Şeyma Memur and Dilek Yavuzcan Öztürk and Onur Bağcı and Halime Sema Can Büker and Meliha Aksoy and Müge Payaslı and Cansu Muluk and Nilay Gündoğdu and Merih Çetinkaya. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG).” Journal of Child, vol. 22, no. 3, 2022, pp. 172-177. [Database Container], https://doi.org/10.26650/jchild.2022.1130184


Vancouver

Yaşa B, Uslu S, Memur Ş, Öztürk D, Bağcı O, Can Büker HS, Aksoy M, Payaslı M, Muluk C, Gündoğdu N, Çetinkaya M. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG). Journal of Child [Internet]. 29 Mar. 2024 [cited 29 Mar. 2024];22(3):172-177. Available from: https://doi.org/10.26650/jchild.2022.1130184 doi: 10.26650/jchild.2022.1130184


ISNAD

Yaşa, Beril - Uslu, Sait İlker - Memur, Şeyma - Öztürk, Dilek Yavuzcan - Bağcı, Onur - Can Büker, HalimeSema - Aksoy, Meliha - Payaslı, Müge - Muluk, Cansu - Gündoğdu, Nilay - Çetinkaya, Merih. THE ABO Hemolytic Disease of Newborn and Effect of Intravenous Immunglobulin G (IVIG)”. Journal of Child 22/3 (Mar. 2024): 172-177. https://doi.org/10.26650/jchild.2022.1130184



TIMELINE


Submitted13.06.2022
First Revision05.07.2022
Last Revision05.07.2022
Accepted02.08.2022
Published Online28.12.2022

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