title: Life-Threatening Hemolytic Anemia after Intrapleural Instillation of OK-432 for Treatment of Congenital Chylothorax.
abstract: Recent reports have advocated treatment of congenital chylothorax with chemical pleurodesis via intrapleural administration of OK-432. Severe complications have not been reported, but recently we have encountered a life-threatening case of massive hemolysis after the procedure. The hemoglobin of the infant decreased from 8.7 to 3.1 g/dl within 48 h, with concomitant severe hyperbilirubinemia (472 μmol/l) requiring exchange transfusion. Frontline neonatologists should be aware of this rare but potentially life-threatening adverse reaction. In addition, it is possible that a longer indwelling time (3.5 vs. 0.5 h) for OK-432 pleurodesis may alter the therapeutic response.
authors.affiliation: Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Steve W P
authors.initials: SW
authors.lastname: Sze
authors.forename: Pak C
authors.initials: PC
authors.lastname: Ng
authors.forename: Hugh S
authors.initials: HS
authors.lastname: Lam
mesh_terms: D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000628:therapy; D002916:Chylothorax / Q000151:congenital* / Q000188:drug therapy; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006932:Hyperbilirubinemia / Q000628:therapy; D007223:Infant; D010844:Picibanil / Q000008:administration & dosage / Q000009:adverse effects*; D018700:Pleurodesis / Q000009:adverse effects*
chemical_list: D006454:Hemoglobins; D010844:Picibanil