Original Article

The Improvement Effect of Different Doses of Gamma Globulin on the Disease Condition of Infants with Hemolytic Disease of Newborn and Their Effects on Immune Factors in Serum


Background: To explore the effect of different doses of Gamma Globulin (GG) on the condition of children with Hemolytic Disease of Newborn (HDN) and the influence of immune factors in serum.

Methods: Overall, 180 infants with hemolytic disease of newborn in the People’s Hospital of Zhangqiu Area, Jinan, China from April 2016 to August 2018 were divided into group A (88 cases) and group B (92 cases). Group A was given intravenous low-dose GG on the basis of phototherapy, and group B was given intravenous high-dose GG on the basis of phototherapy. The level of serum total bilirubin of the infants, the levels of CD3+, CD4+, CD8+, of the infants, the time of jaundice disappearance and the length of hospital stay, hemoglobin and reticulocyte levels were recorded before treatment and after treatment. The number and condition of adverse reactions were recorded.

Results: After treatment, the levels of TBiL, hemoglobin and reticulocyte, the time of jaundice disappearance and hospital stay in group B were significantly lower than those in group A. The level of immune cells in group B was significantly higher than that in group A after 7 days of treatment, and the levels of IgA / IgG / IgM in group B were significantly higher than those in group A after 28 days of treatment.

Conclusion: Intravenous high-dose GG has a better effect on the condition of neonatal hemolytic disease patients, and more effectively improve the immune function of children.

1. Jain A, Malhotra S, Marwaha N, Kumar P, Sharma RR (2018). Severe ABO hemolytic disease of fetus and newborn requiring blood exchange transfu-sion. Asian J Transfus Sci, 12: 176–179.
2. Delaney M, Matthews DC (2015). Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn. Hematology Am Soc Hematol Educ Program, 2015: 146-151.
3. Dava NR, Upadhyaya A, Agarwal N, Mehta A, Choudhary V, Goyal G (2018). A rare case of hemolytic disease of newborn due to weak D (D unknown) antigen in child. Asian J Transfus Sci, 12: 75-77.
4. Kapur R, Della Valle L, Sonneveld M, et al (2014). Low anti-RhD IgG-Fc-fucosylation in pregnancy: a new variable predicting severity in haemolytic disease of the fetus and newborn. Br J Haematol, 166: 936–945.
5. Ree IMC, Smits-Wintjens VEHJ, van der Bom JG, van Klink JMM, Oepkes D, Lopriore E (2017). Neonatal management and outcome in alloim-mune hemolytic disease. Expert Rev Hematol , 10: 607-616.
6. Elhawary IM, Ghany EAGA, Aboelhamed WA, Ib-rahim SGE (2018). Incidence and risk factors of post-phototherapy neonatal rebound hyperbiliru-binemia. World J Pediatr, 14: 350-356.
7. Fekey E, Ibrahim S W, El-Sharkawy H M, et al (2019). Effect of Intravenous Immunoglobulin in Reducing Bilirubin Levels in Hemolytic Disease of Newborn. Egypt J Hospital Med, 74.
8. Zhou F, Long W, Chen J (2012). The Therapeutic Effects of Two Doses of Gammaglobulin for neonatal hemolytic disease. Medical Journal of Chinese People's Health, 15.
9. Taylor E, Vu D, Legare C, Keene D (2015). Intrave-nous immune globulin–related hemolysis: com-paring two different methods for case assess-ment. Transfusion, 55: S23-S27.
10. Erhabor O, Adamu K S, Yakubu A, et al (2014). Singh S. Rh (D) Phenotype among Pregnant Women in Sokoto, North Western Nigeria. Im-plications on Haemolytic Disease of the New-Born and Haemolytic Transfusion Reaction. Health Sci Res, 1: 19-24.
11. Metcalf RA, Khan J, Andrews J, Mayock D, Billimoria Z, Pagano MB (2018). Severe ABO Hemolytic Disease of the Newborn Requiring Exchange Transfusion. J Pediatr Hematol Oncol.
12. De Haas M, Thurik F F, Koelewijn J M, van der Schoot CE (2015). Haemolytic disease of the fetus and newborn. Vox Sang, 109: 99-113.
13. Kumawat V, Kulkarni K, Goyal M, Lokadas V (2017). ABO Hemolytic Disease of Fetus and Newborn; Still a Diagnostic Dilemma: A Case Report. Indian J Hematol Blood Transfus , 34: 183-184.
14. Houston BL, Govia R, Abou-Setta AM, et al (2015). Severe Rh alloimmunization and hemolytic dis-ease of the fetus managed with plasmapheresis, intravenous immunoglobulin and intrauterine transfusion: a case report. Transfus Apher Sci, 53: 399-402.
15. Mundy C A, Bhatia J (2015). Immunoglobulin trans-fusion in hemolytic disease of the newborn: place in therapy. Int J Clin Transfusion Med, 3: 41-45.
16. Elalfy MS, Elbarbary NS, Abaza HW (2011). Early in-travenous immunoglobin (two-dose regimen) in the management of severe Rh hemolytic disease of newborn—a prospective randomized con-trolled trial. Eur J Pediatr, 170: 461-467.
17. Danieli MG, Gelardi C, Pedini V, et al (2014). Subcu-taneous IgG in immune-mediate diseases: pro-posed mechanisms of action and literature review. Autoimmun Rev, 13: 1182-1188
18. Yang L, Wu EY, Tarrant TK (2016). Immune gamma globulin therapeutic indications in im-mune deficiency and autoimmunity. Curr Allergy Asthma Rep, 16: 55.
19. Venkataraman R, Yusuf K (2017). Intravenous im-munoglobulin in the management of a rare cause of hemolytic disease of the newborn: Anti-SARA antibodies. J Neonatal Perinatal Med, 10: 329-332.
20. Zwiers C, van der Bom JG, van Kamp IL, et al (2018). Postponing early intrauterine Transfusion with Intravenous immunoglobulin Treatment; the PETIT study on severe hemolytic disease of the fetus and newborn. Am J Obstet Gynecol, 219: 291.e1-291.e9.
21. Maisonneuve E, Toly-Ndour C, Jouannic JM (2016). Postponing early intrauterine transfusion with in-travenous immunoglobulin treatment: the PETIT study on severe hemolytic disease of the fetus and newborn. World J Clin Pediatr, 5: 182-190.
22. Yang Y, Pan JJ, Zhou XG, Zhou XY, Cheng R, Hu YH (2016). The effect of immunoglobulin treat-ment for hemolysis on the incidence of necrotiz-ing enterocolitis–a meta-analysis. Eur Rev Med Pharmacol Sci , 20: 3902-3910.
23. Tufekci S, Coban A, Bor M, Yasa B, Nisli K, Ince Z (2015). Cardiac rhythm abnormalities during in-travenous immunoglobulin G (IVIG) infusion in two newborn infants: coincidence or association? Clin Case Rep, 3: 731-734.
IssueVol 49 No 5 (2020) QRcode
SectionOriginal Article(s)
Hemolytic disease of newborn; Gamma globulin; Immune function

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How to Cite
HUANG S, LIU L, QIAN G, LIU W, WANG J, Ming LI M, YANG G. The Improvement Effect of Different Doses of Gamma Globulin on the Disease Condition of Infants with Hemolytic Disease of Newborn and Their Effects on Immune Factors in Serum. Iran J Public Health. 2020;49(5):914-922.