title: Intravenous immunoglobulin to treat neonatal alloimmune haemolytic disease.
abstract: OBJECTIVE
  To compare the efficacy of intravenous immunoglobulin (IVIg) and exchange transfusion (EXT) on rhesus haemolytic disease of the newborn (Rh-HDN) and evaluate treatment-related side effects.
  
  
  METHODS
  Retrospective chart review of two cohorts of newborns with Rh-HDN, treated with (Group 2) or without (Group 1) IVIg. Length of phototherapy, number of EXT, IVIg infusions, intrauterine and top-up red blood cells transfusions, need and permanence of umbilical venous catheter, and length of hospital stay, as well as treatment-related adverse events, were evaluated.
  
  
  RESULTS
  Charts of 88 newborns were reviewed (34 in Group 1, 54 in Group 2). Infants in Group 2 received a significantly lower number of EXT, had a lower risk of neurological impairment and needed an umbilical venous catheter for shorter, but required longer phototherapy, longer length of hospital stay, and more top-up transfusions. EXT was associated with a high number of adverse events. Two newborns treated with IVIg developed necrotizing enterocolitis (NEC).
  
  
  CONCLUSIONS
  IVIg appear as an effective alternative to EXT, reducing the risk of neurological impairment and complications related to EXT. However, side effects of IVIg treatment (higher need of top-up transfusions and longer hospital stay) should be taken into account and the risk of NEC should be carefully monitored during treatment.
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy. luigi.corvaglia@unibo.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Corvaglia
authors.forename: Elena
authors.initials: E
authors.lastname: Legnani
authors.forename: Silvia
authors.initials: S
authors.lastname: Galletti
authors.forename: Santo
authors.initials: S
authors.lastname: Arcuri
authors.forename: Arianna
authors.initials: A
authors.lastname: Aceti
authors.forename: Giacomo
authors.initials: G
authors.lastname: Faldella
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000453:epidemiology / Q000628:therapy; D001724:Birth Weight / Q000502:physiology; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000209:etiology; D004899:Erythroblastosis, Fetal / Q000453:epidemiology / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007116:Immunization, Passive / Q000009:adverse effects; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous