{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:33:39Z","timestamp":1787938419564,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:00:00Z","timestamp":1612569600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In Japan, some cases of late\u2010onset acute hemolysis in very low birthweight (VLBW) infants have been reported. These cases had common features but the cause of hemolysis was unknown. The incidence and prognosis of this disease are also unknown. However, there are only few reports of such hemolytic episodes in countries other than Japan. Thus, this study aimed to examine the incidence and clinical course of late\u2010onset acute hemolysis and to establish it as a new disease concept.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nationwide prospective survey was conducted from 2011 to 2015 as a rare disease surveillance project of the Japan Society for Neonatal Health and Development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010four cases were confirmed. The median (range) gestational age, birthweight, and onset of hemolytic episodes were 26\u00a0weeks and 2\u00a0days (23\u00a0weeks and 4\u00a0days\u201331\u00a0weeks and 2\u00a0days), 898\u00a0g (627\u20131,416\u00a0g), and 19\u00a0days after birth (9\u201333\u00a0days), respectively. Phototherapy, blood transfusion, and exchange transfusion were required in 22 (96%), 24 (100%), and 7 (29%) cases, respectively. During the observation period, no recurrence of the hemolytic episode occurred. All patients survived; however, one case developed kernicterus and suffered severe neurological sequelae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, at least 1 out of 1,259 VLBW infants developed hemolysis at 9\u201333\u00a0days after birth in Japan. Owing to the risk of kernicterus, this disease should be recognized as among the important pathological conditions of VLBW infants, suggesting the need to manage jaundice and anemia until 5\u00a0weeks after birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14493","type":"journal-article","created":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T11:15:32Z","timestamp":1601810132000},"page":"172-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nationwide survey of late\u2010onset hemolysis in very low birthweight infants"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-0737","authenticated-orcid":false,"given":"Yayoi","family":"Miyazono","sequence":"first","affiliation":[{"name":"Departments of Department of Child Health Faculty of Medicine University of Tsukuba  Tsukuba Japan"},{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Neonatology Ibaraki Children\u2019s Hospital  Mito Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2960-0555","authenticated-orcid":false,"given":"Yu","family":"Kanai","sequence":"additional","affiliation":[{"name":"Departments of Department of Child Health Faculty of Medicine University of Tsukuba  Tsukuba Japan"},{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5283-7342","authenticated-orcid":false,"given":"Daisuke","family":"Hitaka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8960-1176","authenticated-orcid":false,"given":"Daigo","family":"Kajikawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4341-6973","authenticated-orcid":false,"given":"Shusuke","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5063-0578","authenticated-orcid":false,"given":"Motomichi","family":"Nagafuji","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Fujiyama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0778-3410","authenticated-orcid":false,"given":"Makoto","family":"Saito","sequence":"additional","affiliation":[{"name":"Departments of Department of Child Health Faculty of Medicine University of Tsukuba  Tsukuba Japan"},{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0741-5060","authenticated-orcid":false,"given":"Hidetoshi","family":"Takada","sequence":"additional","affiliation":[{"name":"Departments of Department of Child Health Faculty of Medicine University of Tsukuba  Tsukuba Japan"},{"name":"Department of Pediatrics University of Tsukuba Hospital  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12651"},{"key":"e_1_2_9_3_1","first-page":"442","article-title":"Heinz body hemolytic anemia in extremely low birth weight infants","volume":"32","author":"Miyazono Y","year":"1996","journal-title":"Acta Neonat. 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