Show simple item record

dc.contributor.authorÞórdís Kristinsdóttir
dc.contributor.authorSveinn Kjartansson
dc.contributor.authorHildur Harðardóttir

dc.contributor.authorÞorbjörn Jónsson
dc.date.accessioned2016-08-02T15:09:57Z
dc.date.available2016-08-02T15:09:57Z
dc.date.issued2016-07-05
dc.date.submitted2016
dc.identifier.citationMótefni bundin við rauðkorn nýbura; orsakir og klínískar afleiðingar - Tilfelli greind í Blóðbankanum 2005-2012 2016, 2016 (0708):326 Læknablaðiðen
dc.identifier.issn00237213
dc.identifier.issn16704959
dc.identifier.doi10.17992/lbl.2016.0708.90
dc.identifier.urihttp://hdl.handle.net/2336/617854
dc.descriptionEfst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnen
dc.description.abstractInngangur: Fóstur- og nýburablóðrof stafar af eyðingu fósturrauðkorna vegna rauðkornamótefna móður. Rofið getur leitt til blóðleysis og fósturbjúgs á fósturskeiði og gulu hjá nýburum. Prófið Direct Antiglobulin Test (DAT) greinir mótefni bundin við rauðkorn og er hluti af greiningarferli rofsins. Á Íslandi er DAT gert á naflastrengs-/blóðsýnum nýbura ef móðir er RhD-neikvæð eða hefur rauðkornamótefni önnur en anti-A/-B. Markmið rannsóknarinnar var að rannsaka orsakir og afleiðingar jákvæðs DAT hjá nýburum á Íslandi á 8 ára tímabili. Efniviður og aðferðir: Rannsóknarhópurinn var nýburar með jákvætt DAT á árunum 2005-2012. Úr tölvukerfi Blóðbankans voru sóttar upplýsingar um blóðflokk móður og barns, blóðgjafir og DAT. Úr mæðraskrá fengust upplýsingar um fæðingarþyngd, meðgöngulengd og ljósameðferð. Úr rafrænu sjúkraskrárkerfi Landspítala fengust upplýsingar um meðferð og afdrif nýbura. Niðurstöður: Á árunum 2005-2012 greindust 383 nýburar með jákvætt DAT á Landspítala. Í 73,6% tilvika var orsökin ABO-blóðflokkamisræmi á milli móður og barns, hjá 20,4% voru rauðkornamótefni móður önnur en anti A/-B, hjá 3,9% hvort tveggja, en hjá 2,1% var orsök óljós. Alls fengu 179 (47,6%) börn meðferð vegna jákvæðs DAT með nýburagulu, þar af 167 (93,3%) ljósameðferð eingöngu. Átta nýburar þurftu blóðskiptameðferð, þar af 5 vegna Rhesus-mótefna en þrjú vegna ABO-blóðflokkamisræmis. Ályktun: Jákvætt DAT hjá nýburum á Íslandi árin 2005-2012 stafaði í flestum tilvikum af ABO-blóðflokkamisræmi á milli móður og barns. Tæplega helmingur barnanna þurfti meðhöndlun en oftast nægði ljósameðferð. Í alvarlegustu tilfellum ABO-blóðflokkamisræmis eða rauðkornamótefna annarra en anti-A/-B var þörf á blóðgjöf eða blóðskiptameðferð.
dc.description.abstractIntroduction: Hemolytic disease of the fetus and newborn (HDFN) is caused by the destruction of fetal red blood cells due to red cell antibodies produced by the mother. HDFN can cause fetal hydrops during pregnancy or neonatal jaundice after birth. Direct Antiglobulin Test (DAT) detects antibodies bound to red cells and is a valuable test aiding in the diagnosis of HDFN. In Iceland DAT is routinely performed on cord blood or newborn blood samples if the mother is Rhesus D negative or has non-A/B red cell alloantibodies. The aim of this study was to investigate the causes and consequences of positive DAT in newborns in Iceland over a period of eight years. Material and methods: The study population was infants diagnosed with a positive DAT in the Blood Bank in Iceland in the years 2005-2012. Relevant data on the blood group and antibody status of mother and child, blood transfusion and DAT results were retrieved from the Blood Bank information system ProSang. Birth records provided information on birth weight, gestational age and phototherapy. Health records from the Children's Hospital provided information on the management and fate of the newborn. Results: Over the study period 383 newborns had a positive DAT result at the Blood Bank. In 73.6% of cases the underlying cause was ABO blood group mismatch between mother and infant, in 20.4% of cases the mother had non-A/B red cell alloantibodies, in 3.9% both of above factors were present, while in 2.1% the cause was unclear. A total of 179 (47.6%) children had neonatal jaundice that required treatment, of which 167 (93.3%) only needed phototherapy. Eight infants required exchange transfusion, five of these had Rhesus antibodies and three ABO blood group mismatch. Conclusion: ABO blood group mismatch between mother and child was the most common cause for a positive DAT in neonates in Iceland in the years 2005-2012. Almost half of the neonates required treatment but usually phototherapy was sufficient. Rarely, blood transfusion or exchange transfusion was necessary in severe cases of ABO blood group mismatch or non-A/B red cell alloantibodies.
dc.language.isoisen
dc.publisherLæknafélag Íslands, Læknafélag Reykjavi­kuren
dc.relation.urlhttp://www.laeknabladid.is/tolublod/2016/0708/nr/5953en
dc.rightsArchived with thanks to Læknablaðiðen
dc.subjectNýburalækningaren
dc.subject.meshErythroblastosis, Fetalen
dc.subject.meshHematologic Diseasesen
dc.subject.meshFetal Diseasesen
dc.subject.meshInfant, Newborn, Diseasesen
dc.subject.meshCoombs Testen
dc.subject.meshABO Blood-Group Systemen
dc.subject.meshIsoantibodiesen
dc.subject.meshRh-Hr Blood-Group Systemen
dc.subject.meshJaundice, Neonatalen
dc.subject.meshExchange Transfusion, Whole Blooden
dc.titleMótefni bundin við rauðkorn nýbura; orsakir og klínískar afleiðingar - Tilfelli greind í Blóðbankanum 2005-2012is
dc.title.alternativePositive Coomb’s test in newborns; causes and clinical consequences Summary of cases diagnosed in the Blood Bank in the years 2005 to 2012en
dc.typeArticleen
dc.contributor.department1 Læknadeild Háskóla Íslands, 2 barnadeild Landspítala, 3 kvennadeild Landspítala, 4 Blóðbanka Landspítala.en
dc.identifier.journalLæknablaðiðen
dc.rights.accessOpen Accessen
refterms.dateFOA2018-09-12T16:06:56Z
html.description.abstractInngangur: Fóstur- og nýburablóðrof stafar af eyðingu fósturrauðkorna vegna rauðkornamótefna móður. Rofið getur leitt til blóðleysis og fósturbjúgs á fósturskeiði og gulu hjá nýburum. Prófið Direct Antiglobulin Test (DAT) greinir mótefni bundin við rauðkorn og er hluti af greiningarferli rofsins. Á Íslandi er DAT gert á naflastrengs-/blóðsýnum nýbura ef móðir er RhD-neikvæð eða hefur rauðkornamótefni önnur en anti-A/-B. Markmið rannsóknarinnar var að rannsaka orsakir og afleiðingar jákvæðs DAT hjá nýburum á Íslandi á 8 ára tímabili. Efniviður og aðferðir: Rannsóknarhópurinn var nýburar með jákvætt DAT á árunum 2005-2012. Úr tölvukerfi Blóðbankans voru sóttar upplýsingar um blóðflokk móður og barns, blóðgjafir og DAT. Úr mæðraskrá fengust upplýsingar um fæðingarþyngd, meðgöngulengd og ljósameðferð. Úr rafrænu sjúkraskrárkerfi Landspítala fengust upplýsingar um meðferð og afdrif nýbura. Niðurstöður: Á árunum 2005-2012 greindust 383 nýburar með jákvætt DAT á Landspítala. Í 73,6% tilvika var orsökin ABO-blóðflokkamisræmi á milli móður og barns, hjá 20,4% voru rauðkornamótefni móður önnur en anti A/-B, hjá 3,9% hvort tveggja, en hjá 2,1% var orsök óljós. Alls fengu 179 (47,6%) börn meðferð vegna jákvæðs DAT með nýburagulu, þar af 167 (93,3%) ljósameðferð eingöngu. Átta nýburar þurftu blóðskiptameðferð, þar af 5 vegna Rhesus-mótefna en þrjú vegna ABO-blóðflokkamisræmis. Ályktun: Jákvætt DAT hjá nýburum á Íslandi árin 2005-2012 stafaði í flestum tilvikum af ABO-blóðflokkamisræmi á milli móður og barns. Tæplega helmingur barnanna þurfti meðhöndlun en oftast nægði ljósameðferð. Í alvarlegustu tilfellum ABO-blóðflokkamisræmis eða rauðkornamótefna annarra en anti-A/-B var þörf á blóðgjöf eða blóðskiptameðferð.
html.description.abstractIntroduction: Hemolytic disease of the fetus and newborn (HDFN) is caused by the destruction of fetal red blood cells due to red cell antibodies produced by the mother. HDFN can cause fetal hydrops during pregnancy or neonatal jaundice after birth. Direct Antiglobulin Test (DAT) detects antibodies bound to red cells and is a valuable test aiding in the diagnosis of HDFN. In Iceland DAT is routinely performed on cord blood or newborn blood samples if the mother is Rhesus D negative or has non-A/B red cell alloantibodies. The aim of this study was to investigate the causes and consequences of positive DAT in newborns in Iceland over a period of eight years. Material and methods: The study population was infants diagnosed with a positive DAT in the Blood Bank in Iceland in the years 2005-2012. Relevant data on the blood group and antibody status of mother and child, blood transfusion and DAT results were retrieved from the Blood Bank information system ProSang. Birth records provided information on birth weight, gestational age and phototherapy. Health records from the Children's Hospital provided information on the management and fate of the newborn. Results: Over the study period 383 newborns had a positive DAT result at the Blood Bank. In 73.6% of cases the underlying cause was ABO blood group mismatch between mother and infant, in 20.4% of cases the mother had non-A/B red cell alloantibodies, in 3.9% both of above factors were present, while in 2.1% the cause was unclear. A total of 179 (47.6%) children had neonatal jaundice that required treatment, of which 167 (93.3%) only needed phototherapy. Eight infants required exchange transfusion, five of these had Rhesus antibodies and three ABO blood group mismatch. Conclusion: ABO blood group mismatch between mother and child was the most common cause for a positive DAT in neonates in Iceland in the years 2005-2012. Almost half of the neonates required treatment but usually phototherapy was sufficient. Rarely, blood transfusion or exchange transfusion was necessary in severe cases of ABO blood group mismatch or non-A/B red cell alloantibodies.


Files in this item

Thumbnail
Name:
f01 (3).pdf
Size:
364.5Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record