Neonatal ABO Incompatibility

Abstract

The authors present two infants with isoimmune hemolytic disease due to ABO incompatibility complicated by massive hemoglobinuria and secondary acute renal failure. This represents an incidence of 0.36% of all neonates with ABO hemolytic disease in the author's newborn population. Only two patients have been reported previously to have similar complications.

Analysis of data of these four infants revealed the clinical characteristics of this complication of ABO incompatibility: 1) very low frequency ; 2) early onset of hemoglobinuria (first voided urine) and of acute renal failure (first 2 days of life); 3) lack of correlation between the clinical presentation of hemolytic disease and appearance and severity of renal failure; 4) complete recovery of renal functions following intravenous fluid administration; and 5) normal renal radiologic investigations.

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References

Raffi A. , Hatt J. , Bauman P. , et al. Hemoglobinurie due vraisemblablement à une incompatibilite ABO chez un nouveau-né qui presentait en outre une image radiologique paramediastinale droite anormale. Soc Franc Pediat 1964;19:757-60.

Angella JJ , Prieto EN , Fogel BJ Hemoglobinuria associated with hemolytic disease of the newborn infant . J Pediatr 1967;71:530-3.

Sivan Y. , Merlob P. , Nutman J. , et al. Direct hyperbilirubinemia complicating ABO hemolytic disease of the newborn. Clin Pediatr 1983;22:537-8.

Schwartz GY , Brion LP , Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin N Amer 1987;34:571-90.

Ahmadian Y. , Lewy PR Possible urate nephropathy of the newborn infant as a cause of transient renal insufficiency. J Pediatr 1977;91:96-100.

Brezis M. , Rosen S. , Epstein FH Acute renal failure. In: Brenner BH , Recelov FC eds., The kidney. Philadelphia: WB Saunders , 1986:743-5.