Abstract：
High neonatal bilirubin is a common phenomenon responding to phototherapy. We report a case of a newborn with a highly elevated bilirubin of 37.3 mg/dL due to ABO incompatibility between the mother (Group O) and the newborn (Group A) requiring whole blood exchange, a procedure performed rarely to treat newborn hyperbilirubinemia. The newborn (38.8 weeks of gestation) initially showed a total bilirubin of 8.4 mg/dL and was discharged after being stabilized by phototherapy. However, the baby returned to the hospital with highly elevated bilirubin and was admitted to the Neonatal Intensive Care Unit (NICU). Emergent reconstituted whole blood exchanger therapy was initiated due to refractoriness to phototherapy and IVIG. Markedly elevated anti-A titer was found in the mother\'s blood (1:512) and cord blood (1:128). The baby was stabilized and eventually discharged with a serum bilirubin of 13.8 mg/dL. This case demonstrates the possible predictive value of mother/cord blood anti-A titers in severe newborn hyperbilirubinemia, which may prevent premature discharge and trigger early initiation of lifesaving therapy.
摘要：
新生儿高胆红素是光疗的常见现象。我们报告了一例新生儿，由于母亲（O组）和需要全血交换的新生儿（A组）之间的ABO不相容，胆红素高度升高为37.3mg/dL。一种很少用于治疗新生儿高胆红素血症的手术。新生儿（妊娠38.8周）最初显示总胆红素为8.4mg/dL，经光疗稳定后出院。然而,婴儿因胆红素高度升高而返回医院,并入住新生儿重症监护病房(NICU).由于对光疗和IVIG的难治性，开始了紧急的重组全血交换器治疗。在母亲血液(1:512)和脐带血(1:128)中发现抗A滴度显著升高。婴儿稳定并最终出院，血清胆红素为13.8mg/dL。此病例证明了母亲/脐带血抗A滴度在严重新生儿高胆红素血症中的可能预测价值，这可以防止过早出院，并触发早期开始救生治疗。
