‘Haptoglobin concentrations in preterm and term newborns’

Chávez-Bueno, Susana; Beasley, Joann; Goldbeck, Jessica Marie; Bright, Brianna C.; Morton, Daniel J.; Whitby, Paul W.; Stull, Terrence L.

doi:10.1038/jp.2010.197

Cited by 33 publications

(26 citation statements)

References 28 publications

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“…Plasma levels of haptoglobin and hemopexin have been previously described to increase in children and adults with sepsis [25-29]. Often regarded as an acute-phase reactant in response to physiologic stress, haptoglobin levels have been utilized in algorithms to aid in the diagnosis of sepsis [25,28]; however evidence to suggest that haptoglobin and hemopexin levels are associated with clinical outcomes in patients with sepsis beyond their properties as acute-phase reactants is lacking.…”

Section: Introductionmentioning

confidence: 99%

“…Often regarded as an acute-phase reactant in response to physiologic stress, haptoglobin levels have been utilized in algorithms to aid in the diagnosis of sepsis [25,28]; however evidence to suggest that haptoglobin and hemopexin levels are associated with clinical outcomes in patients with sepsis beyond their properties as acute-phase reactants is lacking. Specifically, it is unknown whether haptoglobin and hemopexin levels are only a marker of illness or if elevations in sepsis have a protective function and are associated with improved outcomes independent of severity of illness and cell-free hemoglobin levels.…”

Section: Introductionmentioning

confidence: 99%

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Association between haptoglobin, hemopexin and mortality in adults with sepsis

et al. 2013

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IntroductionPlasma levels of cell-free hemoglobin are associated with mortality in patients with sepsis; however descriptions of independent associations with free hemoglobin and free heme scavengers, haptoglobin and hemopexin, are lacking beyond their description as acute phase reactants. We sought to determine the association of plasma levels of endogenous free hemoglobin and haptoglobin and hemopexin with in-hospital mortality in adults with sepsis.MethodsWe conducted a retrospective observational study of a total of 387 critically ill patients with sepsis in multiple intensive care units in an academic tertiary care hospital. Measurements of plasma haptoglobin and hemopexin were made on blood drawn within 24 hours of intensive care unit admission. The primary outcome was the association between plasma haptoglobin and hemopexin with in-hospital mortality.ResultsSurvivors had significantly higher plasma haptoglobin concentrations (median 1234 μg/ml, interquartile range (IQR) 569 to 3037) and hemopexin concentrations (616 μg/ml, IQR 397 to 934) measured on enrollment compared to non-survivors (haptoglobin 750 μg/ml, IQR 404 to 2421, P = 0.008; hemopexin 470 μg/ml, IQR 303 to 891, P = 0.012). After controlling for potential confounders including cell-free hemoglobin concentration, patients with higher haptoglobin concentrations were significantly less likely to die in the hospital (odds ratio (OR) 0.653, 95% CI 0.433 to 0.984, P = 0.042), while the same association was not seen with hemopexin (OR 0.53, 95% CI 0.199 to 1.416, P = 0.206). In a subgroup analysis, the association between increased haptoglobin and hemopexin and decreased risk of mortality was no longer significant when analyzing patients with no detectable cell-free hemoglobin (P = 0.737 and P = 0.584, respectively).ConclusionIn critically ill patients with sepsis, elevated plasma levels of haptoglobin were associated with a decreased risk of in-hospital mortality and this association was independent of confounders. Increased haptoglobin may play a protective role in sepsis patients who have elevated levels of circulating cell-free hemoglobin beyond its previous description as an acute phase reactant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between haptoglobin, hemopexin and mortality in adults with sepsis

et al. 2013

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“…10 Jaundice is the most common presenting feature of HS in neonates. 11 In addition, the typically sluggish erythropoietic response of neonates often renders the reticulocyte count low relative to the degree of anemia 10 ; spherocytes are less often observed on the blood smear of neonates; and other markers of hemolysis seen in older patients, such as low haptoglobin levels, 12 may be poor indicators of hemolysis in the neonate.…”

Section: Making the Diagnosis Of Hs In A Neonatementioning

confidence: 99%

A Pediatrician’s Practical Guide to Diagnosing and Treating Hereditary Spherocytosis in Neonates

2015

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Newborn infants who have hereditary spherocytosis (HS) can develop anemia and hyperbilirubinemia. Bilirubin-induced neurologic dysfunction is less likely in these neonates if the diagnosis of HS is recognized and appropriate treatment provided. Among neonates listed in the USA Kernicterus Registry, HS was the third most common underlying hemolytic condition after glucose-6-phosphate dehydrogenase deficiency and ABO hemolytic disease. HS is the leading cause of direct antiglobulin test (direct Coombs) negative hemolytic anemia requiring erythrocyte transfusion in the first months of life. We anticipate that as physicians become more familiar with diagnosing HS in the newborn period, fewer neonates with HS will develop hazardous hyperbilirubinemia or present to emergency departments with unanticipated symptomatic anemia. We predict that early suspicion, prompt diagnosis and treatment, and anticipatory guidance will prevent adverse outcomes in neonates with HS. The purpose of this article was to review the neonatal presentation of HS and to provide practical and up-to-date means of diagnosing and treating HS in neonates.

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“…Simple ways to support a diagnosis of hemolysis include finding hemoglobin without erythrocytes in the urine on a standard urine analysis and finding pink serum on a visual examination of a blood sample. Also, the absence of haptoglobin in the serum can be tested rapidly and inexpensively and supports a diagnosis of hemolysis [13,14]. However, haptoglobin levels can be low in neonates without hemolysis, thus haptoglobin analysis alone can be an unreliable parameter for judging neonatal hemolysis.…”

Section: Considering Hemolysis As a Causative Mechanism (Table 1)mentioning

confidence: 99%

Neonatal Hemolytic Jaundice: Morphologic Features of Erythrocytes That Will Help You Diagnose the Underlying Condition

2014

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Background: Many cases of severe neonatal hyperbilirubinemia never have the underlying cause of the jaundice clearly identified. Thus they are said to have ‘idiopathic' severe neonatal jaundice. However, finding the exact cause, if it is a genetic condition, can enable informed anticipatory guidance regarding future episodes of hemolysis, anemia, or bilirubin cholelithiasis. Objective: ‘Next generation' gene sequencing can often reveal the mutations responsible for severe neonatal hyperbilirubinemia, but wisely using this new technology involves selective application, employing this testing only if inexpensive technology fails to reveal the diagnosis. Methods: In this review, we display and discuss five types of red blood cell morphological abnormalities that have helped us categorize cases of neonatal hemolytic jaundice. Results: As an aid to applying inexpensive technology, we review morphological abnormalities of erythrocytes that are easily identified on a blood film. When found, these abnormalities can be important clues to the underlying hemolytic condition giving rise to neonatal jaundice. Conclusions: Applying these simple and inexpensive methods can assist neonatologists in caring for neonates who have hemolytic jaundice. We predict that by using these principles the term ‘idiopathic' neonatal jaundice will become less common as the underlying causes are identified.

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‘Haptoglobin concentrations in preterm and term newborns’

Cited by 33 publications

References 28 publications

Association between haptoglobin, hemopexin and mortality in adults with sepsis

Association between haptoglobin, hemopexin and mortality in adults with sepsis

A Pediatrician’s Practical Guide to Diagnosing and Treating Hereditary Spherocytosis in Neonates

Neonatal Hemolytic Jaundice: Morphologic Features of Erythrocytes That Will Help You Diagnose the Underlying Condition

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