Aydın ERDEMİR, Ebru TÜRKOĞLU, Hese COŞAR, Zelal KAHRAMANER, Sümer SÜTÇÜOĞLU, Esra ÖZER ARUN

Rh uygunsuzluğuna bağlı direkt bilirubin ve CRP yüksekliği: Olgu sunumu

Ağır hemolizi olan Rh uygunsuzluğu vakalarında şiddetli hiperbilirubinemi, anemi ve splenomegali yaygın görülen özelliklerdir. Ancak ciddi direkt bilirubin ve CRP yüksekliği nadir görülmektedir. Burada yaşamın ilk gününde Rh uygunsuzluğuna bağlı hiperbilirubinemi nedeniyle kliniğimize yatırılan, şiddetli direkt hiperbilirubinemi ve CRP yüksekliğinin de bulunduğu ağır hemolizi olan bir yenidoğan olgusu sunuldu. Nadirde olsa, ciddi Rh uygunsuzluğuna direkt bilirubin ve CRP yüksekliğinin eşlik edebileceği vurgulanmak istendi.

Rh incompatibility with high direct bilirubin and crp levels: A case report

Significant hyperbilirubinemia, anemia, and splenomegaly are common features in cases of Rh incompatibility with severe hemolysis whereas conjugated hyperbilirubinemia and high CRP levels are uncommon. Herein, we reported a newborn referred to our clinic because of hyperbilirubinemia due to Rh incompatibility on the first day of life with conjugated hyperbilirubinemia. She had severe hemolysis with conjugated hyperbilirubinemia and high CRP levels. Rarely, we wanted to emphasized that high conjugated bilirubin and CRP levels may be associated with severe Rh incompatibility.

PDF

___

1. Fitzgerald JF. Cholestatic disorders of infancy. Pediatr Clin North Am 1988;35:357.
2. Yilmaz S, Duman N, Ozer E, et al. A case of rhesus hemolytic disease with hemophagocytosis and severe iron overload due to multiple transfusions. J Pediatr Hematol Oncol 2006;28:290-292.
3. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.
4. Bertini G, Dani C, Fonda C, Zorzi C, Rubaltelli FF. Bronze baby syndrome and the risk of kernicterus. Acta Paediatr 2005;94:968-971.
5. Ahlfors CE. Measurement of plasma unbound unconjugated bilirubin. Anal Biochem 2000;279:130-135.
6. Zanella A, Bianchi P. Red cell pyruvate kinase deficiency: from genetics to clinical manifestations. Baillieres Best Pract Res Clin Haematol 2000;13:57-81.
7. Smits-Wintjens VE, Walther FJ, Lopriore E. Rhesus haemolytic disease of the newborn: Postnatal management, associated morbidity and long-term outcome. Semin Fetal Neonatal Med 2008;13:265-271.
8. Perez EM, Cooper TR, Moise AA, Ferry GD, Weisman LE. Treatment of obstructive jaundice in erythroblastosis fetalis with ursodeoxycholic acid (UCDA): a case report. J Perinat 1998;18:317-319.
9. Pepys MB. C-reactive protein fifty years on. Lancet 1981;21:653-657.
10. Woollard KJ, Phillips DC, Griffiths HR. Direct modulatory effect of C-reactive protein on primary human monocyte adhesion to human endothelial cells. Clin Exp Immunol 2002;130:256-262.
11. Martínez-Subiela S, Cerón JJ. Effects of hemolysis, lipemia, hyperbilirrubinemia, and anticoagulants in canine C-reactive protein, serum amyloid A, and ceruloplasmin assays. Can Vet J. 2005;46:625-629.
12. Bhutani VK, Johnson LH, Maisels MJ, et al. Kernicterus: epidemiological strategies for its prevention through systems-based approaches. J Perinatol 2004;24:650-662.