A case of rhesus hemolytic disease with hemophagocytosis and severe iron overload due to multiple transfusions.
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.
Yilmaz
Sebnem
S
Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey. sebnem.yilmaz@deu.edu.tr
Duman
Nuray
N
Ozer
Esra
E
Kavas
Nazan
N
Oren
Hale
H
Demircioğlu
Fatih
F
Kumral
Abdullah
A
Ozkan
Hasan
H
Irken
Gülersu
G
Ozer
Erdener
E
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
D003676:Deferoxamine