title: A case of rhesus hemolytic disease with hemophagocytosis and severe iron overload due to multiple transfusions.
abstract: BACKGROUND
  A newborn with cholestatic hepatic disease and hemophagocytic lymphohistiocytosis due to rhesus hemolytic disease (RHD) is reported.
  
  
  METHODS
  A 34 weeks' gestation baby with RHD, who had received multiple intrauterine transfusions (IUT), developed cholestatic hepatic disease and secondary hemophagocytic lymphohistiocytosis (HLH). Her serum ferritin level increased to 5,527 ng/mL, and liver biopsy showed severe iron overload. Treatment with intravenous desferrioxamine resulted in a marked decrease in serum ferritin levels and normalization of liver function
  
  
  CONCLUSIONS
  We suggest that patients who have undergone IUT be evaluated for hyperferritinemia. If hyperferritinemia is noted, chelation therapy should be considered. As another rare finding, HLH can complicate the course of RHD.
authors.affiliation: Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey. sebnem.yilmaz@deu.edu.tr
authors.forename: Sebnem
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Nuray
authors.initials: N
authors.lastname: Duman
authors.forename: Esra
authors.initials: E
authors.lastname: Ozer
authors.forename: Nazan
authors.initials: N
authors.lastname: Kavas
authors.forename: Hale
authors.initials: H
authors.lastname: Oren
authors.forename: Fatih
authors.initials: F
authors.lastname: Demircioğlu
authors.forename: Abdullah
authors.initials: A
authors.lastname: Kumral
authors.forename: Hasan
authors.initials: H
authors.lastname: Ozkan
authors.forename: Gülersu
authors.initials: G
authors.lastname: Irken
authors.forename: Erdener
authors.initials: E
authors.lastname: Ozer
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000628:therapy; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000628:therapy; D003676:Deferoxamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019190:Iron Overload / Q000209:etiology* / Q000628:therapy; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology* / Q000628:therapy; D065227:Transfusion Reaction
chemical_list: D003676:Deferoxamine