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Modified double-volume exchange transfusion in 2 infants with severe pertussis and hyperleukocytosis
1Department of Blood Transfusion, Shengjing Hospital of China Medical University, Shenyang, China.
Insights
Modified exchange transfusion effectively treated severe pertussis (whooping cough) in infants with high white blood cell counts. This procedure improved breathing and reduced white blood cell levels safely, leading to successful recovery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Pertussis, caused by Bordetella pertussis, is an acute respiratory illness.
- Hyperleukocytosis in pertussis worsens prognosis, leading to pulmonary hypertension, multiorgan failure, and increased mortality.
- Exchange transfusion is a potential treatment to improve outcomes in pediatric pertussis.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified exchange transfusion in infants with severe pertussis and hyperleukocytosis.
Main Methods:
- Retrospective analysis of 2 infants with severe pertussis treated with modified exchange transfusion.
- Preparation of reconstituted whole blood with specific ratios of leukoreduced red blood cells and plasma.
- Total exchange volume of 150-180 mL/kg (approximately 2 blood volumes).
Main Results:
- Both infants experienced a significant reduction in white blood cell count post-transfusion.
- Clinically significant improvement in dyspnea was observed in both patients.
- No severe adverse reactions were reported, and both infants were discharged.
Conclusions:
- Modified double-volume exchange transfusion is a safe and effective therapeutic option for infants suffering from severe pertussis complicated by hyperleukocytosis.
Introduction:
Pertussis is an acute respiratory infectious disease caused by Bordetella pertussis. Hyperleukocytosis in pertussis contributes to a drastically worsened prognosis by promoting pulmonary hypertension and multiorgan failure, leading to accelerated disease progression and elevated mortality. Exchange transfusion can improve the prognosis of in children with pertussis and increase the success rate of treatment.
Methods:
We retrospectively analyzed 2 infants with severe pertussis treated with modified exchange transfusion. Reconstituted whole blood was prepared using O-type leukoreduced concentrated red blood cells and AB-type leukocyte-reduced, virus-inactivated fresh frozen plasma, with a red blood cell to plasma ratio of 1:1 to 2:1 and a hematocrit of 40% to 50%. The total exchange volume was 150 to 180 mL/kg (approximately twice the blood volume).
Results:
After exchange transfusion, both infants showed marked reduction in white blood cell count and clinically significant improvement in dyspnea. No severe adverse reactions occurred, and both children were discharged.
Discussion:
Modified double-volume exchange transfusion is a safe and effective treatment for infants with severe pertussis and hyperleukocytosis.
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