High dose intravenous immunoglobulin therapy in neonatal immune hemolytic jaundice

ABSTRACT

Isoimmune hemolytic jaundice due to blood group [ABO] and Rhesus [Rh] incompatibility is an important problem in the neonatal period. A controlled study was conducted to assess the role of high dose intravenous immunoglobulin [HDIVIG] therapy in neonatal immune hemolytic jaundice. Newborn patients with ABO and/or Rh incompatibilities proved by significant hyperbilirubinemia [>15mg/dl], positive direct Coombs' test and high reticulocytic count [>6%] were randomly assigned to receive either conventional treatment measures alone, including phototherapy and exchange transfusion if needed [control group, n=10 newborns] or phototherapy with high dose i.v. immunoglobulin [1gm/kg] over 4 hours [study group, n=30 newborns] as soon as the diagnosis was established. One of the 30 patients in the HDIVIG group required exchange transfusion, while this became necessary in 3 of 10 patients in the control group [p<0.001]. The duration of phototherapy and hospitalization, in terms of hours were significantly shorter in the HDIVIG group [p<0.001]. No adverse effects of HDIVIG therapy were observed. The use of HDIVIG therapy in newborns with ABO and/or Rh hemolytic disease reduces hemolysis, serum bilirubin levels, the need for blood exchange transfusion and the duration of hospitalization