Acute Hemolytic Anemia in Very Low Birth Weight Infants: A Series of Cases

Abstract

We report on 10 premature infants with acute hemolytic anemia and Heinz bodies treated from 1999 to 2007 and discuss their clinical characteristics. All patients were very low birth weight infants (mean gestational age, 27 weeks; range, 24～30 weeks; mean birth weight, 889g; range, 598～1,412g), and hemolytic anemia developed after cardiopulmonary adaptation had been achieved. Heinz body appeared an average of 20 days after birth (range, 11～25 days), and hemolysis persisted for an average of 9 days (range, 4～16 days) and spontaneously resolved. Hemolytic anemia and jaundice developed suddenly, during which time Heinz bodies were observed on hematologic examination. The affected infants showed refractory apnea just before the onset of hemolytic anemia.
The exact cause of these hemolytic episodes remains unclear. However, the immature antioxidant function of the red blood cell membrane against oxygen radicals was a suspected cause, because most of the infants required ventiratory managements with high concentration of supplemental oxygen.