Severe iron overload and hyporegenerative anemia in a case with rhesus hemolytic disease: therapeutic approach to rare complications.
A 33 weeks' gestation, a baby with rhesus hemolytic disease (RHD), who had received intrauterine transfusions twice, developed cholestatic hepatic disease and late hyporegenerative anemia. Her serum ferritin and bilirubin levels increased to 8842 ng/ml and 17.9 mg/dl, respectively. Liver biopsy showed cholestasis and severe iron overload. Treatment with recombinant erythropoietin (rHuEPO) decreased the transfusion need, and intravenous deferoxamine resulted in a marked decreased in serum ferritin levels and normalization of liver function. In patients who have undergone intrauterine transfusions due to RHD, hyperferritinemia and late hyporegenerative anemia should be kept in mind. Chelation therapy in cases with symptomatic hyperferritinemia and rHuEPO treatment in cases with severe hyporegenerative anemia should be considered.
Dörtçelik Children's Hospital, Bursa, Turkey, Phone: +90 505 525 03 47 E-mail: fatih_demircioglu@yahoo.com.
Fatih
F
Demircioğlu
Şule
Ş
Çağlayan Sözmen
Şebnem
Ş
Yılmaz
Hale
H
Ören
Nur
N
Arslan
Abdullah
A
Kumral
Erdener
E
Özer
Gülersu
G
İrken