High-dose intravenous immunoglobulin therapy in neonatal immune haemolyticjaundice

A controlled study was conducted to assess the role of high-dose i.v. immun oglobulin (HDIVIG) therapy in neonatal immune haemolytic jaundice. Patients with ABO and/or Rh incompatibilities proved by significant hyperbilirubina emia (>204 mmol l(-1)), positive direct antiglobulin test and high reticulo cyte count (greater than or equal to 10%) were randomly assigned to receive either conventional phototherapy alone or phototherapy with high-dose i.v. immunoglobulin (1 g kg(-1), over 4 h) as soon as the diagnosis was establi shed. Exchange transfusions were performed if serum bilirubin concentration s exceeded 290 mmol l(-1) and increased by more than 17 mmol l(-1) per h de spite both treatment manoeuvres. Eight of 58 patients in the HDIVIG group r equired exchange transfusions, whereas it became necessary in 22 of 58 pati ents in the control group (p < 0.001). The durations of phototherapy and ho spitalization in terms of hours were significantly shorter in the HDIVIG gr oup (p < 0.05). No side effects of HDIVIG therapy were observed. In conclus ion, HDIVIG therapy in newborns with ABO or Rh haemolytic diseases reduces haemolysis, serum bilirubin levels and the need for blood exchange transfus ion, a procedure which has potential complications and carries a risk of mo rtality.