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Published on: March 14, 2013
Late anaemia in infants with rhesus haemolytic disease treated with intensive phototherapy
Insights
Intensive phototherapy effectively treats rhesus hemolytic disease (RHD) in infants. While some infants develop late anemia, the reticulocyte response suggests phototherapy
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Phototherapy Research
Background:
- Rhesus hemolytic disease (RHD) is a condition affecting newborns.
- Late anemia can be a complication in infants with RHD.
- Phototherapy is a common treatment for RHD.
Purpose of the Study:
- To determine the incidence of late anemia in infants with RHD treated with intensive phototherapy.
- To compare the incidence and timing of late anemia in infants who received exchange transfusion versus those who did not.
- To investigate the reticulocyte response in infants developing late anemia.
Main Methods:
- Prospective follow-up of 60 infants with RHD and positive direct Coombs' tests.
- Infants received intensive blue double light phototherapy.
- Out-patient monitoring for the development of late anemia and Hb levels.
Main Results:
- 25% of infants developed moderate anemia, and 8% developed severe anemia.
- Incidence of late anemia was similar in "non-exchanged" and "exchanged" infants.
- A marked reticulocyte response was observed in both groups as Hb levels declined.
Conclusions:
- Intensive phototherapy is highly effective in managing RHD.
- The reticulocyte response may mitigate the severity of late anemia in treated infants.
- Phototherapy, particularly intensive regimens, offers significant therapeutic value for RHD.
Abstract:
The purpose of the present study was to determine the incidence of late anaemia in infants with rhesus haemolytic disease (RHD) who had received intensive phototherapy. Sixty infants with RHD and with strongly positive direct Coombs' tests who had received intensive phototherapy (blue double light) were followed as out-patients with regard to development of late anaemia. Fifteen (25%) infants developed moderate anaemia and 5 (8%) severe anaemia, one of the latter requiring a blood transfusion. The incidence of late anaemia was equal in "non-exchanged" infants and those who required exchange transfusion. The former developed anaemia significantly earlier than the latter, and in both groups the declining Hb level caused a marked reticulocyte response which was equal in both groups. This response may explain the low incidence of anaemia in both the "non-exchanged" and "exchanged" infants. From the present study and previous investigations it can be concluded that phototherapy, especially intensive phototherapy, is of great value in the treatment of rhesus haemolytic disease.
