Article Text

Unusual cause of severe neonatal hyperbilirubinaemia: a twin case
  1. Shikha Khandelwal,
  2. Aakash Pandita,
  3. Girish Gupta and
  4. Anita Singh
  1. Department of Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Aakash Pandita, aakash.pandita{at}


We present twins born to the 31-year-old, multigravida mother, who were referred to our centre at 90 hours of life for severe hyperbilirubinaemia. Twin 1 had already received two double volume exchange transfusions at 55 and 83 hours of life, in view of the persistent rise in bilirubin despite receiving phototherapy. Twin 2 had received phototherapy and 1 packed red blood cell transfusion in view of the fall in haematocrit. Mother’s blood group was B positive and that of both twins was O positive. Both the twins were started on intensive phototherapy and their serum bilirubin and haematocrit were evaluated. On investigation, a minor blood incompatibility was found. Double volume exchange transfusion was done for twin 2 at 100 hours of life in view of the rapid rise in serum bilirubin. Both the babies were monitored for their serum bilirubin and treated for sepsis and discharged after 15 days.

  • haematology (drugs and medicines)
  • immunological products and vaccines
  • paediatrics (drugs and medicines)
  • immunology
  • neonatal intensive care
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  • Contributors SK and AP wrote the manuscript. GG and AS did the final corrections. GG and AP did the critical appraisal.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/Guardian consent obtained.

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