Follow up of children after antenatal treatment for alloimmune thrombocytopenia
| Autor: | Humphrey H.H. Kanhai, Gerlinde M. S. J. Stoelhorst, Sylvia Veen, Celine M. Radder, Monique J.J. de Haan, Anneke Brand |
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| Rok vydání: | 2004 |
| Předmět: |
Pediatrics
medicine.medical_specialty Offspring Blood Transfusion Intrauterine Immunoglobulins Platelet Transfusion Atopy Child Development Pregnancy hemic and lymphatic diseases medicine Humans Lost to follow-up Adverse effect Child Purpura Thrombocytopenic Idiopathic biology business.industry Obstetrics and Gynecology Immunoglobulins Intravenous Infant medicine.disease Combined Modality Therapy Human platelet antigen Fetal Diseases El Niño In utero Child Preschool Pediatrics Perinatology and Child Health Neonatal alloimmune thrombocytopenia biology.protein Female business Follow-Up Studies |
| Zdroj: | Early human development. 80(1) |
| ISSN: | 0378-3782 |
| Popis: | Objective To evaluate the long-term follow-up of surviving offspring after antenatal treatment for fetal or neonatal alloimmune thrombocytopenia (FNAIT). Patients Fifty children at risk of FNAIT were antenatally treated with maternal intravenous immunoglobulins (IVIG) (n=11), IVIG with intrauterine platelet transfusions (IUPT) (n=26) or IUPT alone (n=9). In four cases (n=4), only fetal blood sampling (FBS) was performed. One child died in the neonatal period and one was lost to follow up. Methods The remaining 48 children, aged 1.3–11.6 years (median 5.1 years), were given both general and neurological examinations and assessed on their development and susceptibility for infections or atopic constitution. In addition, immunoglobulin levels were measured in 17 infants, aged 5 years and older. Results Intracranial hemorrhage (ICH) was not observed. The general health and neurodevelopmental outcome in the children was comparable to a normal Dutch population. Children not exposed to maternal IVIG treatment had significantly more infections and hearing problems than children exposed to IVIG treatment or the normal population. Immunoglobulin G, A and M levels were within the normal range, independent of treatment and severity of FNAIT. A high IgE level was more frequently seen in children exposed to IVIG, but did not result in clinical consequences such as allergy or atopy. Conclusions Antenatal treatment of children for FNAIT did not affect general health or neurodevelopmental outcome. In particular, exposure to IVIG in utero showed no adverse effect on the clinical outcome of these children. |
| Databáze: | OpenAIRE |
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