静脉注射丙种免疫球蛋白致新生儿ABO溶血症加重1例

A Case of Neonatal ABO Hemolysis Aggravated by Intravenous Injection of Gamma Immunoglobulin

摘要: 1例以“发现皮肤黄染加重2天”之代诉入院的患儿，在给与蓝光照射退黄治疗后，黄疸消退不明显，于生后第10天给与静脉注射丙种球蛋白2.5 g/次，共使用2天，于生后第12天复查血常规示WBC：12.46 × 109，Hb：74 g/L，血红蛋白较前明显下降，送交叉配血发现患儿血与同血型的献血者血液无法配对，给予输注O型洗涤红细胞后血红蛋白上升，至121 g/L，治疗6天痊愈出院。该病例提示，大量输注丙种球蛋白有加重或导致溶血的可能，考虑输注丙球时应该慎重，对于临床上的任何用药或治疗手段，不应只关注其治疗作用，还应考虑其不良反应和并发症的发生。

Abstract: One case complained on behalf of “skin yellowing was found to be aggravated for 2 days”. After blue light irradiation, jaundice did not subside significantly. On the 10th day after birth, intravenous in-jection of 2.5 g/time gamma globulin was given for 2 days. On the 12th day after birth, blood rou-tine examination showed that WBC was 12.46 × 109. Hb was 74 g/l, and hemoglobin was signifi-cantly lower than that before. It was found that the blood of the child could not be matched with that of the blood donor of the same blood type by sending cross matching blood. After infusion of type O washed red blood cells, hemoglobin increased to 121 g/l, and recovered after 6 days of treatment. This case suggests that a large amount of gamma globulin infusion may aggravate or cause hemolysis, so we should be careful when considering gamma globulin infusion. For any clini-cal medication or treatment, we should not only pay attention to its therapeutic effect, but also con-sider the occurrence of its adverse reactions and complications.