Abstract
Objective: Indirect hyperbilirubinemia is an important problem in newborns and phototherapy has an important role in treatment. The aim of this study is to evaluate the effects of phototherapy on hematological parameters in newborns with indirect hyperbilirubinemia.
Materials and Methods: January 2021- March 2022, 60 newborns (term = 30 and preterm = 30) diagnosed and treated for indirect hyperbilirubinemia were included in this study.
Results: Twelve of the term babies (40%) had either Rh (n = 3) or ABO incompatibility (n = 9). Ten of the preterms (33%) had either Rh (n = 3) or ABO incompatibility (n = 7). The median values of phototherapy time of term and preterm newborns were 24 (range, 6-40) and 11 hours (range, 4-36), respectively. After phototherapy, WBC and RBC counts, Hb, MCV and RDW values of term newborns decreased significantly. In preterm newborns white blood cell count, red blood cell count, hemoglobin, mean corpuscular volume of red blood cells, red blood distribution width (WBC and lymphocyte, counts and Hb, MCV and RDW) values decreased significantly, while a statistically significant increase in mean corpuscular hemoglobin concentration (MCHC) values and the percentage of monocyte counts were determined.
Conclusion: Our study suggests that phototherapy has various effects on hematological parameters. Some of these effects can be explained by Rh or ABO incompatibility, but prospective studies including more patients are needed to explain the changes in hematological parameters in newborns without Rh or ABO incompatibility.
Keywords
Newborn Indirect Hyperbilirubinemia Phototherapy Hematologic Parameters Yenidoğan Direk Hiperbilirubinemi Fototerapi Hematolojik Parametreler
References
- REFERENCES 1. Erdeve O, Okulu E, Olukman O, Ulubas D, et al. The Turkish Neonatal Jaundice Online Registry: A national root cause analysis. PLoS One. 2018; 13(2): e0193108.
- 2. Kaplan M, Bromiker R, Hammerman C. Severe neonatal hyperbilirubinemia and kernicterus: are these still problems in the third millennium? Neonatology. 2011; 100(4): 354-62.
- 3. Bratlid D, Nakstad B, Hansen TW. National guidelines for treatment of jaundice in the newborn. Acta Paediatr. 2011; 100(4): 499-505.
- 4. Çoban A, Türkmen MK, Gürsoy T. Turkish Neonatal Society guideline to the approach, follow-up, and treatment of neonatal jaundice. Turk Pediatri Ars. 2018; 53(Suppl 1): S172-S179.
- 5. Xiong T, Qu Y, Cambier S, Mu D. The side effects of phototherapy for neonatal jaundice: what do we know? What should we do? Eur J Pediatr. 2011; 170(10): 1247-55.
- 6. Altuntas N, Dogan OC, Kislal FM. Effect of phototherapy on neutrophil VCS parameters and white blood cells. J Coll Physicians Surg Pak. 2019; 29(5): 453-5.
- 7. Aydın B, Beken S, Zenciroğlu A, Dilli D, Okumuş N. Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy. Iran J Pediatr. 2014; 24(3): 267-72.
- 8. Eyada IK, El Saie AL, Ibrahem GA, Riad NM. Effect of phototherapy on B and T lymphocytes in Egyptian infants suffering from neonatal jaundice. Allergol Immunopathol (Madr). 2017; 45(3): 290-6.
- 9. Aycicek A, Kocyigit A, Erel O, Senturk H. Phototherapy causes DNA damage in peripheral mononuclear leukocytes in term infants. J Pediatr (Rio J). 2008; 84(2): 141-6.
- 10. Kurt A, Aygun AD, Kurt AN, Godekmerdan A, et al. Use of phototherapy for neonatal hyperbilirubinemia affects cytokine production and lymphocyte subsets. Neonatology. 2009; 95(3):262-6.
- 11. Caliskan U, Acar A, Oner AF, Acar H, et al. The effect of phototherapy on the sister chromatid exchange rate of chromosomes. S.U. Tıp Fakültesi Dergisi 1990; 6(3): 281-6.
- 12. Koc H, Akoz M, Gurbilek M, Ak M, et al. The effect of phototherapy on free radicals in newborns with hyperbilirubinemia. Genel Tip Derg. 1999; 9(3): 87-91.
- 13. Koc H, Altunhan H, Dilsiz A, Kaymakci A, et al. Testicular changes in newborn rats exposed to phototherapy. Pediatr Dev Pathol. 1999; 2(4):333-6.
- 14. Khan NM, Poduval TB. Immunomodulatory and immunotoxic effects of bilirubin: molecular mechanisms. J Leukoc Biol. 2011 90(5): 997-1015.
Abstract
Amaç: İndirekt hiperbilirubinemi yenidoğanlarda önemli bir sorundur ve tedavide fototerapi önemli biryere sahiptir. Bu çalışmanın amacı indirekt hiperbilirubinemili yenidoğanlarda fototerapinin hematolojik parametreler üzerindeki etkilerini değerlendirmektir.
Gereç ve Yöntemler: Ocak 2021- Mart 2022 tarihleri arasında indirekt hiperbilirubinemi tanısı alan ve tedavi edilen 60 yenidoğan (term = 30 ve preterm = 30) bu çalışmaya dahil edildi.
Bulgular: Yenidoğan dönemlerinin 12'sinde (%40) Rh uyuşmazlığı (n = 3) veya ABO uyuşmazlığı (n = 9) vardı, erken doğmuş yenidoğanların 10'unda (%33) Rh uyuşmazlığı (n = 3) veya ABO uyuşmazlığı vardı. (n = 7). Zamanında ve erken doğmuş yenidoğanların medyan fototerapi süreleri sırasıyla 24 (dağılım, 6-40) ve 11 saat (aralık, 4-36) idi. Fototerapi sonrası term bebeklerde beyaz küre sayısı, kırmızı küre sayısı, hemoglobin, kırmızı kan hücreleri ortalama korpüsküler hacmi, kırmızı kan dağılım genişliği (WBC ve RBC, Hb, MCV ve RDW) değerlerinin istatistiksel olarak anlamlı oranda azaldığı saptandı. Preterm yenidoğanlarda WBC ve lenfosit, Hb, MCV ve RDW değerlerinde istatistiksel olarak anlamlı oranda azalma olurken, ortalama korpüsküler hemoglobin konsantrasyonu (MCHC) değerleri ve monosit yüzdelerinde artış saptandı.
Sonuç: Çalışmamız fototerapinin bazı hematolojik parametreler üzerine etkisi olduğunu düşündürmektedir. Bu etkilerin bir kısmı Rh veya ABO uyuşmazlığı ile açıklanabilir, ancak Rh veya ABO uyuşmazlığı olmayan yenidoğanlarda hematolojik parametrelerdeki değişiklikleri açıklamak için daha fazla hastada prospektif çalışmalara ihtiyaç vardır.
References
- REFERENCES 1. Erdeve O, Okulu E, Olukman O, Ulubas D, et al. The Turkish Neonatal Jaundice Online Registry: A national root cause analysis. PLoS One. 2018; 13(2): e0193108.
- 2. Kaplan M, Bromiker R, Hammerman C. Severe neonatal hyperbilirubinemia and kernicterus: are these still problems in the third millennium? Neonatology. 2011; 100(4): 354-62.
- 3. Bratlid D, Nakstad B, Hansen TW. National guidelines for treatment of jaundice in the newborn. Acta Paediatr. 2011; 100(4): 499-505.
- 4. Çoban A, Türkmen MK, Gürsoy T. Turkish Neonatal Society guideline to the approach, follow-up, and treatment of neonatal jaundice. Turk Pediatri Ars. 2018; 53(Suppl 1): S172-S179.
- 5. Xiong T, Qu Y, Cambier S, Mu D. The side effects of phototherapy for neonatal jaundice: what do we know? What should we do? Eur J Pediatr. 2011; 170(10): 1247-55.
- 6. Altuntas N, Dogan OC, Kislal FM. Effect of phototherapy on neutrophil VCS parameters and white blood cells. J Coll Physicians Surg Pak. 2019; 29(5): 453-5.
- 7. Aydın B, Beken S, Zenciroğlu A, Dilli D, Okumuş N. Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy. Iran J Pediatr. 2014; 24(3): 267-72.
- 8. Eyada IK, El Saie AL, Ibrahem GA, Riad NM. Effect of phototherapy on B and T lymphocytes in Egyptian infants suffering from neonatal jaundice. Allergol Immunopathol (Madr). 2017; 45(3): 290-6.
- 9. Aycicek A, Kocyigit A, Erel O, Senturk H. Phototherapy causes DNA damage in peripheral mononuclear leukocytes in term infants. J Pediatr (Rio J). 2008; 84(2): 141-6.
- 10. Kurt A, Aygun AD, Kurt AN, Godekmerdan A, et al. Use of phototherapy for neonatal hyperbilirubinemia affects cytokine production and lymphocyte subsets. Neonatology. 2009; 95(3):262-6.
- 11. Caliskan U, Acar A, Oner AF, Acar H, et al. The effect of phototherapy on the sister chromatid exchange rate of chromosomes. S.U. Tıp Fakültesi Dergisi 1990; 6(3): 281-6.
- 12. Koc H, Akoz M, Gurbilek M, Ak M, et al. The effect of phototherapy on free radicals in newborns with hyperbilirubinemia. Genel Tip Derg. 1999; 9(3): 87-91.
- 13. Koc H, Altunhan H, Dilsiz A, Kaymakci A, et al. Testicular changes in newborn rats exposed to phototherapy. Pediatr Dev Pathol. 1999; 2(4):333-6.
- 14. Khan NM, Poduval TB. Immunomodulatory and immunotoxic effects of bilirubin: molecular mechanisms. J Leukoc Biol. 2011 90(5): 997-1015.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 30, 2022 |
| Submission Date | January 31, 2022 |
| Published in Issue | Year 2022 |