Hemolytic Disease

Updated: June 26, 2023

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

rho(D) immune globulin

Indicated for In newborns, administration to the mother for prevention of Hemolytic Disease
Postpartum: 1500 international units intravenously/intramuscularly within 72 hours
Antepartum: 1500 international units, nearly 300 mcg intravenously/intramuscularly at 28-30 weeks of the gestation
If both are given, the risk decreases to 0.1%
If it is not possible to administer the treatment within 72 hours, give it within the 28 days; and it is advised not to withhold
If >15 mL of the Rho+ fetal Red blood cells are present in the mother's circulation, then multiple 1500 International Units doses are essential
Abortion/Miscarriage for Obstetric Conditions
1500 international units intravenously/intramuscularly, one dose within 72 hours
MicRhoGAM/HyperRHO: If abortion occurs within 13 weeks, then give 250 International Units/50 mcg
Nonsplenectomised Rho(D)-Positive individuals Immune Thrombocytopenic Purpura
Initial, if Hgb >10 gm/dl: 250 international units/Kg intravenously one time
Initial, if Hgb <10 gm/dl: 250 international units/Kg intravenously one time
Extra doses: 125-300 International units/Kg intravenously as needed
Infuse intravenously over 3-5 minutes
If it is unresponsive to the initial dose and if Hgb <8 g/dl, use different therapy
Incompatible Transfusions
Rhophylac
1 mL erythrocyte concentrate Or 20 mcg (100 international units)/2 ml blood intravenously/intramuscular
WinRho SDF
Intramuscular: 12 mcg (60 international units)/ml blood
Intravenously: 9 mcg (45 international units)/ml blood