Summary
A newborn of normal birthweight received fresh blood transfusions and procoagulant fractions during his first days for a haemorrhagic disease. Three months later the infant had acute liver failure. Liver biopsy revealed a massive hepatic necrosis and an Australia antigen was detected. 1ml/kg of anti-HB gamma globulin was administered after each of two exchange transfusions (200 ml/kg). Anti-HB antibodies were detected after gamma globulin therapy. Once the passively administered antibodies had disappeared, the HB titer increased, and the child seemed physically and mentally normal seven months after the infection. These observations are difficult to interpret but immunity of the child seems possible.
Zusammenfassung
Wegen eines Blutungsübels erhielt ein normalgewichtiges Neugeborenes antihämophile Serum-Fraktionen und Frischbluttransfusionen. Drei Monate später bot das Kind das Krankheitsbild eines schweren akuten Leberversagens. Die Leberbiopsie ergab eine massive hepatische Nekrose, ferner wurde Australia-Antigen nachgewiesen. Nach zwei Austauschtransfusionen (200 ml/kg) wurde zusätzlich 1 ml/kg eines Antihepatitis-B-Gamma-Globulins verabreicht. Antihepatitis-B-Antikörper wurden nach der Gamma-Globulin-Therapie nachgewiesen. Nachdem nun die passiven Antikörper verschwunden waren, stieg der HB-Titer erneut an, und das Kind entwickelte sich innerhalb der nächsten sieben Monate physisch und geistig normal. Aus der Beobachtung wurde geschlossen, daß trotz der Gamma-Globulin-Gabe eine Immunisierung möglicherweise stattgefunden haben könnte.
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Dupuy, J.M., Virelizier, J.L. & Frommel, D. Fulminant hepatitis-virus B in a three months old infant: Therapeutic trial with specific anti-HB globulins in antibody excess. Infection 1, 62–64 (1973). https://doi.org/10.1007/BF01638260
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DOI: https://doi.org/10.1007/BF01638260