Neutropenia Complicating Rh-Hydrops Fetalis: The Effect of Treatment with Recombinant Human Granulocyte Colony-Stimulating Factor (rhG-CSF)

Abstract

Neutropenia is a less commonly encountered feature of Rh hemolytic disease of the newborn, and its management may be problematic. Two newborn infants with neutropenia complicating Rh incompatibility—induced hydrops fetalis were treated with intravenous recombinant human granulocyte colony-stimulating factor (rhG-CSF), 5 μg/kg/day for 5 days. Both patients responded to therapy with a rapid and persistent increase of their neutrophil counts to normal values. The treatment was well tolerated and no adverse clinical events were observed. rhG-CSF induces a significant increase in peripheral absolute neutrophil counts of neutropenic neonates with Rh hydrops fetalis and was well tolerated. The contribution of rhG-CSF to clinical recovery warrants further investigation.

Key Words:

• G-CSF
• hydrops
• neutropenia
• Rh incompatibility

Additional information

Notes on contributors

Nirit Segal

Joyce Laing works in the Department of Child and Family Psychiatry, Playfield House, Cupar, Fife, and is a Consultant Art Therapist to Psychiatric Hospitals and Prisons and Chairwoman of the Scottish Society of Art and Psychology.

Dr Niculescu Dan, Centrul de Reumatologie, Str. J. (F)ucick no. 5, Bucuresti, Romania

Anni Vilppula, Department of Medicine, Paimio Hospital, Preitilä, Finland

G. Tausch, Department of Rheumatology, Municipal Hospital of Vienna-Lainz, Wolkersbergenstraße 1, A-1130Wien, Austria

Dr Guido Gothoni, Medica Pharmaceutical Company Ltd., P.O. Box 325, SF-00101 Helsinki 10, Finland

A. Elman, Dept. of Rheumatology, Karolinska sjukhuset, Stockholm, Sweden

Hannu Paitälä, Rheumatism Foundation Hospital, Heinola, Finland

Jonas Jonsson, National Bacteriological Laboratory, S-105 21 Stockholm, Sweden