Their efficacy and good tolerance prompt consideration of IVIg as a therapeutic adjuvant to PT in severe hemolytic hyperbilirubinemia due to ABO incompatibility.Ĭopyright © 2014.
ABO incompatibility is more often seen in newborns who have type A blood because of the higher frequency of type A compared to type B in most populations. IVIG associated with PT reduces the need for ET and the duration of PT in newborns with hyperbilirubinemia due to ABO hemolytic disease. ABO incompatibility is the most common maternal-fetal blood group incompatibility and the most common cause of hemolytic disease of the newborn (HDN). The tolerance of the IVIg and PT association was good with no reported cases of ulcerative enterocolitis in 265 treated newborns. The mean duration of PT was 4 days in the PT group and association of PT with IVIg significantly reduced the duration of PT treatment by 0.84 days. Requirement for ET was lower in the IgIV+PT group, with a relative risk of 0.27, expressed as a number needed to treat of five neonates to avoid one ET. The program provides powerful X-ray and neutron powder diffraction simulation capabilities. IVIg doses ranged from 0.5 to 1.5 g/Kg in one to three administrations. CrystalDiffract is a program that liberates your powder diffraction data from the lab: placing you firmly in control with easy measurement and analysis tools, combined with real-time XRD/neutron simulations. A meta-analysis of the selected data was performed on six selected trials out of 28 found.
Duration of PT and adverse events were optional criteria. Intravenous human polyclonal immunoglobulins (IVIg) have been proposed in concomitant use with PT in order to avoid the requirement for ET in ABO FMI.Įlectronic databases of all published clinical trials in neonatal hyperbilirubinemia due to ABO incompatibility were systematically queried for randomized controlled clinical trials comparing PT alone to PT associated with IVIg based on the requirement for ET. Severe hyperbilirubinemia can be prevented by first-line phototherapy (PT) treatment, but exchange transfusion (ET) is required if treatment is not effective, even if ET is linked with high hemodynamic, infectious, gastrointestinal, and/or biological morbidity. High levels of unconjugated hyperbilirubinemia may induce acute and chronic neurological complications.
ABO hemolytic disease (ABO HD) remains the most frequent cause of severe and early jaundice in newborns. ABO fetomaternal red blood cell incompatibility (ABO FMI) induces an immune hemolysis after fetal transfer of hemolyzing maternal anti-A or anti-B.
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