Haemolytic disease of the newborn Flashcards
What is the cause of haemolytic disease of the newborn?
Maternal antibodies against foetal blood group antigens
this can occur due to placenta cross or mix at delivery causing haemolysis
Clinical features of haemolytic disease of the newborn
yellow amniotic fluid
hydrops fetalis
pallor
jaundice <2 days post birth
investigations for haemolytic disease of the newborn
DAT +ve
haemolysis : raised unconjugated bilirubin and reticulocytes
How to prevent haemolytic disease of the newborn?
anti-D immunoglobulin
Given at 28 weeks, 34 weeks and birth
and given at any sensitising event
How to manage haemolytic disease of the newborn
Exchange transfusion
Phototherapy to remove bilirubin
IVIG
What is immune thrombocytopenic purpura?
Immune mediated reduction in platelet
a type 2 hypersensitivity reaction
What type of hypersensitivity causes ITP?
Type 2
What causes ITP?
May occur after infection or vaccination
Symptoms of ITP?
Bruising with petechial or purpuric rash
How to investigate for ITP?
FBC
Blood film
Bone marrow exam if atypical features such as splenomegaly
How to manage ITP?
self resolving
Sickle cell disease prophylaxis?
Immunisations against encapsulated organisms
Daily oral penicllin and folic acid
Avoid vaso-occlusive crisis triggers*
* cold, dehydration, excessive exercise
What can cause aplastic anaemia in a person with sickle cell?
Parovovirus B19
low reticulocytes
Acute crisis in sickle cell management?
analgesia! 1st step
fluids, oxygen
exchange transfusion if acute chest syndrome
What to give for chronic problems with sickle cell?
Hydroxycarbamide - stimulates HbF production
