RESUMO
This study comprises 120 full-term infants with ABO hemolytic disease admitted to the neonatal department during a period of 60 months from 1970-1975. During the first 30 months newborns (n = 61) received no D-penicillamine therapy, whereas all infants (n = 59) received this treatment (300-400 mg/kg/day, divided into 4 equal doses, for 2-5 days) during the last 30 months. The patients were further subdivided into two groups according to the point of time when D-penicillamine treatment was begun, viz. group I (34 treated and 34 control infants) within the first 24 h of life; group II (25 treated and 27 control infants) after the third day of life. In group I D-penicillamine therapy caused a marked decline of serum bilirubin concentrations at a time when such levels were rising in the control infants. The number of exchange transfusions per infant was 1.32 in the control and 0.11 in the D-penicillamine-treated infants. In group II D-penicillamine considerably reduced the number of exchange transfusions (0.70:0.24 = control:treated) but the difference was statistically not significant. In the latter patients the mean bilirubin values showed a smaller difference compared to the controls than in group I. Since group I represented the results of early or preventive treatment, while group II those of late or therapeutic treatment, it is obvious that, for ensuring success, D-penicillamine treatment should be begun as early as possible in ABO hemolytic disease of the newborn.
Assuntos
Sistema ABO de Grupos Sanguíneos , Eritroblastose Fetal/tratamento farmacológico , Penicilamina/uso terapêutico , Fatores Etários , Bilirrubina/sangue , Eritroblastose Fetal/prevenção & controle , Transfusão Total , Feminino , Humanos , Recém-Nascido , Masculino , Penicilamina/administração & dosagem , Penicilamina/efeitos adversos , Gravidez , Estudos Retrospectivos , Fatores de TempoRESUMO
A total 330 newborns suffering from haemolytic disease of the newborn and hyperbilirubinaemia was treated with D-penicillamine. The therapy resulted in a significant decrease in the frequency of exchange transfusions and of high serum bilirubin levels among preterm and fullterm babies with or without sensitization. Concerning the drug's mechanism of action, reduction of the bilirubin level is achieved by means of the copper stored in the liver. The intravenous route is suggested for application of the drug. In preterm infants D-penicillamine treatment proved more effective than phototherapy.