Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/20599

In Collections

This item can be found in the following collections:

Rath, M.E.A. (2013)

Hematological outcome in neonatal alloimmune hemolytic disease

Doctoral Thesis
This thesis focuses on several aspects related to the hematological outcome of infants with hemolytic disease of the fetus and newborn (HDFN) due to red blood cell alloimmunization, including pathogenesis and management of the disease. The presence of leukocytopenie and thrombocytopenia support the mechanism of suppression of thrombopoiesis and granulopoiesis in favor of the increased erythropoiesis stimulated by anemia and hypoxia. In addition to the problems caused by a shortage of platelets and white and red blood cells, the excess of the red blood cell metabolites bilirubin and iron also contribute to the morbidity of the disease. This thesis also contains a systematic review that demonstrates that there is lack of high level evidence promoting the use of intravenous immunoglobulin (IVIg) to prevent exchange transfusions in HDFN. Irrespective of the controversy concerning the use of IVIg, this thesis shows that intensive follow-up is indicated in both Rhesus D and non-Rhesus D...Show moreThis thesis focuses on several aspects related to the hematological outcome of infants with hemolytic disease of the fetus and newborn (HDFN) due to red blood cell alloimmunization, including pathogenesis and management of the disease. The presence of leukocytopenie and thrombocytopenia support the mechanism of suppression of thrombopoiesis and granulopoiesis in favor of the increased erythropoiesis stimulated by anemia and hypoxia. In addition to the problems caused by a shortage of platelets and white and red blood cells, the excess of the red blood cell metabolites bilirubin and iron also contribute to the morbidity of the disease. This thesis also contains a systematic review that demonstrates that there is lack of high level evidence promoting the use of intravenous immunoglobulin (IVIg) to prevent exchange transfusions in HDFN. Irrespective of the controversy concerning the use of IVIg, this thesis shows that intensive follow-up is indicated in both Rhesus D and non-Rhesus D HDFN and raised awareness about the associated morbidity is of paramount importance. Finally, this thesis also contains future research questions concerning HDFN.Show less
Top-up transfusion
Intrauterine transfusion
Hemolytic disease of the newborn
Exchange transfusion
Alloimmunization
All authors
Rath, M.E.A.
Supervisor
Walther, F.J.
Co-supervisor
Lopriore, E.
Qualification
Doctor (dr.)
Awarding Institution
Leiden University Medical Center (LUMC), Leiden University
Date
2013-03-07
ISBN (print)
9789461916422

Funding

Sponsorship
Department of Pediatrics Leiden University Medical Center (Willem-Alexander Kinderziekenhuis); Nutrica Nederland BV; Sanquin Bloedvoorziening; Abbott BV; Department of Obstetrics and Fetal Medicine Leiden University Medical Center; Vygon BV.