Acute hemoglobin increase after transfusion and immunoglobulin for rhesus hemolytic disease of the newborn

Goronwy Owen Hughes, Joseph Osman, Anne Marie Coady, Hilary Klonin

Journal of Clinical Neonatology 2018 7(1):48-50

We describe two infants with severe hemolytic disease of the fetus and newborn (HDFN) with hepatosplenomegaly treated with intravenous immunoglobulin. Packed red blood cells (PRBC) were transfused resulting in an acute disproportionate increase in hemoglobin with clinical consequences in one case. These cases appear to highlight previously unreported sequelae. We discuss a hypothetical mechanism and suggest that the effect warrants further research as a possible way to decrease the need for and risks of PRBC transfusion in HDFN.

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