Shift from fetal to adult hemoglobin production in a preterm infant after exchange transfusion: a quantitative approach.
To evaluate the quantitative aspects of the shift in production from fetal hemoglobin (HbF) to adult hemoglobin (HbA), the HbF and HbA mass were estimated in a preterm infant (gestational age 29 weeks) for 22 weeks after an exchange transfusion the second day of life, leading to an initial HbA% of 100. Up until the estimated time of delivery, the HbA mass declined continuously, at a rate corresponding to a survival time of the transfused HbA erythrocytes of 100 days, and the rise in total hemoglobin mass could be ascribed solely to a rise in the HbF mass. HbF% maximum was reached 3 weeks before HbF mass maximum, and, thus, the HbF% and HbA% time courses gave no basis for evaluation of the production/destruction balance of HbF and HbA erythrocytes. The applied quantitative approach seems to be a useful additional procedure for evaluating the switch from HbF to HbA production and for estimating HbA erythrocyte survival time in preterm infants.
Institute for Respiratory Physiology, Ullevål University Hospital, Oslo, Norway.
H E
HE
Refsum
A G
AG
Bechensteen
R
R
Lindemann
D000751:Anemia, Neonatal / Q000097:blood / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood; D005319:Fetal Hemoglobin / Q000096:biosynthesis*; D005865:Gestational Age; D006441:Hemoglobin A / Q000096:biosynthesis*; D006801:Humans; D007231:Infant, Newborn
D006441:Hemoglobin A; D005319:Fetal Hemoglobin