Darbepoetin Alfa for Late-onset Anemia in Neonates with Rhesus Hemolytic Disease.

Neonates with Rhesus hemolytic disease can present with anemia beyond 1 wk of age due to bone marrow suppression and low erythropoietin secretion. Erythropoietin stimulating agents (ESA) were tried to manage anemia in these neonates. Darbepoetin alfa (DA) is a long-acting ESA used to treat anemia in premature neonates and in children with chronic kidney disease or on cancer chemotherapy. The authors present their experience of using DA to treat late-onset hyporegenerative anemia in 3 neonates with Rhesus isoimmunization. Darbepoetin alfa 4 mcg/kg was given subcutaneously at a 1-2-wk interval to target hemoglobin of 10-12 g/dL. No adverse effects were observed, and the treated infants had a reduced need for the packed red blood cell transfusions.

Enfermedad hemolítica perinatal causada por anticuerpos anti-M y tratada con inmunoglobulinas intravenosas fetales / Hemolytic disease of the fetus due to anti-M antibodies treated with fetal intravenous immunoglobulin therapy

Presentamos el caso de una mujer de 28 años, con 2 abortos tardíos previos causados por anticuerpos anti-M. En la actual gestación es tratada desde la semana 23 hasta la semana 34 con inmunoglobulinas intravenosas fetales, con resultado satisfactorio. Aunque no hay estudios randomizados y controlados que indiquen que las inmunoglobulinas fetales son efectivas en el manejo de la isoinmunización, pequeñas series de casos sugieren resultados prometedores (AU)

We present the case of a 28-year-old woman with two prior late miscarriages caused by anti-M antibodies, leading to alloimmunization of her previous pregnancies. During this pregnancy, she was successfully treated with intravenous immunoglobulins administered from the 23th to the 34th week of pregnancy. There are no randomized trials to indicate whether the antenatal use of intravenous immunoglobulin is effective in the management of fetal red blood cell alloimmunization. Several case series suggest a beneficial role in preventing severe fetal anemia (AU)

[Isoimmune haemolytic icterus in neonatal calves as a consequence of vaccination against piroplasmosis]. / Isoimmunhämolytischer Ikterus bei Kälbern in Folge einer Piroplasmose-Schutzimpfung.

The article refers about several cases of isoimmunohaemolytic icterus in neonatal calves from different farms, whose dams had all been vaccinated against piroplasmosis. Clinical signs of immunomediated icterus neonatorum gravis, results of blood chemistry (with special regard to liver-specific parameters in the neonatal calf and results of haematology) as well as gross pathology and pathohistology are to be discussed. It is summarized, that the most relevant indicators for a hepatopathy in the newborn calf are total-bilirubin and the glutamate-dehydrogenase. Today, the production of piroplasmosis-vaccines out of blood of splenectomized animals is referred to as the only practicable method of harvesting sufficient amounts of vaccine-antigen.

Chronic copper poisoning in sheep. III. The distribution of soluble copper- and zinc-binding liver proteins of lambs compared with adult sheep.

The distribution of copper and zinc among soluble hepatic proteins in lambs from 1 normal and 1 copper dosed ewe was studied by gel filtration. It was found that the distribution pattern is similar in newborn lambs and transfer and accumulation of copper is possible in lambs.

Possible effect of maternal promethazine therapy on neonatal immunologic functions.

The effect of the administration of promethazine in the treatment of erythroblastosis fetalis was studied in four maternal-fetal pairs. The three infants exposed for a prolonged period of time had decreased neonatal number and function of T cells, and abnormal specific humoral immune responses. The possible role of promethazine in the induction of fetal immunoincompetence is discussed.

Hydrops fetalis and stillbirth in a male glucose-6-phosphate dehydrogenase-deficient fetus possibly due to maternal ingestion of sulfisoxazole; a case report.

PIP: A woman pregnant with her second child was given sulfisoxazole (Gantrisin) during her eighth month of pregnancy for a urinary tract infection. Her 34-week-old male infant was stillborn with hydrops fetalis and severe anemia. The mother was found to be glucose-6-phosphate-dehydrogenase (G-6-PDH) deficient. Ingestion of the drug which is known to produce hemolysis in G-6-PDH-deficient people may have compromised the male infant by creating an abundance of bilirubin via massive hemolysis and also retarding its elimnation by competing with bilirubin for albumin-binding sites. This case identifies a newly recognized danger in the use of sulfonzmides in the third trimester of pregnancy.^ieng