Necrotizing enterocolitis following the use of intravenous immunoglobulin for haemolytic disease of the newborn.
OBJECTIVE
To describe a series of patients who received intravenous immunoglobulin (IVIg) for the treatment of neonatal hyperbilirubinaemia and developed necrotizing enterocolitis (NEC) shortly thereafter.


RESULTS
We describe three healthy breastfed newly born infants with isoimmunization-derived hyperbilirubinaemia refractory to phototherapy who were treated with IVIg. Shortly after the perfusion finished they developed clinical and radiological signs compatible with NEC and needed antibiotic therapy, prolonged parenteral nutrition and even surgery in one case. Other conditions such as septicaemia or coagulopathy were ruled out. Microscopic examination of the resected intestine revealed the presence of disseminated thrombi obstructing multiple minor vessels of the mesenteric circulation.


CONCLUSIONS
IVIg in the newborn period should be cautiously employed and always administered under strict medical control.
Navarro
Mariel
M
Division of Neonatology, University Hospital La Fe, Valencia, Spain.
Negre
Sergio
S
Matoses
María Luisa
ML
Golombek
Sergio G
SG
Vento
Maximo
M
D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001942:Breast Feeding; D003937:Diagnosis, Differential; D020345:Enterocolitis, Necrotizing / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000150:complications / Q000628:therapy*; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D007231:Infant, Newborn; D008297:Male; D010288:Parenteral Nutrition; D010789:Phototherapy; D011859:Radiography; D012203:Rh Isoimmunization / Q000150:complications
D000900:Anti-Bacterial Agents; D016756:Immunoglobulins, Intravenous