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Newborns with severe enterovirus infection
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| bet | 305/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Newborns with severe enterovirus infection: In infants <7 days age at presentation with severe enterovirus infection (hepatitis with coagulopathy and thrombocytopenia) caused by coxsackievirus B, early IVIg therapy 2–2.5 g/kg was independently associated with a favourable prognosis. [13] (LOE IV, GOR C)
Neonatal hemochromatosis – gestational alloimmune liver disease (GALD): No controlled clinical trials have assessed the efficacy of IVIg for GALD. Several observational studies reported improved outcomes of pregnancies at risk of GALD with antenatal IVIg. [14–16] There is less evidence for use of postnatal IVIg in infants with GALD. In the largest, historical control study, the majority received either no disease directed therapy (N = 46) or a cocktail of chelation and antioxidants (N = 54). Their overall rate of survival was 13%. IVIg/double volume exchange therapy was applied to 20 patients, with 9 (45%) surviving, and 14 received a liver transplant with 6 (43%) surviving. [17] National Blood Authority proposed recommendation: Neonate with neonatal hemochromatosis – Maintenance IVIg 1–2 g/kg following exchange transfusion in the first 7 days and then 1 g/kg weekly, as required. The aim should be to use the lowest dose possible that achieves the appropriate clinical outcome for each patient. Dosing above 1 g/kg per day is contraindicated for some IVIg products. [18] [LOE III-3, GOR C]
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