Reticulocytosis and direct coombs test as markers of haemolysis in neonatal hyperbilirubinemia requiring phototherapy
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 6, Issue 2
Abstract
Background: Neonatal hyperbilirubinemia is seen in 60% full-term neonates in first week of life. Among these8-11 % require phototherapy. Causes of hyperbilirubinemia can be immune or non-immune causes. Reticulocytosis and Direct Coombs test positivity can be markers for haemolytic hyperbilirubinemia. Objective: To identify the incidence of reticulocytosis in immune and non-immune mediated haemolyticjaundice, to note whether thereis any significant difference in reticulocytosis between the two groups and to identify the association if any between reticulocytosis and Direct Coombs test. Methods: Aprospective study was done in a teaching institution including 100 term neonates requiring phototherapy. They were categorized into three groups as possible immune haemolytic(divided into Rh and ABO incompatibility) and possible non immune cause as per the maternal and baby blood groups. Reticulocyte count and Coombs test were done on starting phototherapy. Statistical analysis was done with SPSS version 20.0. Descriptive statistics, Chi-square test and Fisher’s exact test were used for analysis. Results: Rh incompatibility group showed 100% positivity for both reticulocytosis and Direct Coombs test. In ABO incompatibility group reticulocytosis was 56.5% and Coombs positivity was 84.6%. 5% of those babies with Noincompatibility had reticulocytosis. Direct Coombs test was positive in 7.4% of babies in this group. There was a significant association between haemolytic cause of hyperbilirubinemia and reticulocytosis .No association seen between reticulocytosis and Coombs test positivity in ABO incompatibilitynor in No incompatibility group. Conclusion: Reticulocytosis, Coombs positivity are good markers to identify haemolysisas the major cause of hyperbilirubinemia
Authors and Affiliations
Rugmini Kamalammal, Sanjay K Masaradd, K E Elizabeth
Keywords
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