Tin-mesoporphyrin in the treatment of severe hyperbilirubinemia in a very-low-birth-weight infant.

Tin-mesoporphyrin (SnMP) is a competitive inhibitor of microsomal heme oxygenase (the rate-limiting enzyme in the heme catabolic pathway). It was administered as a single intramuscular dose at 46 hours of life to a very-low-birth-weight infant with severe hemolytic hyperbilirubinemia who had been awaiting an exchange transfusion. This case documents the effective elimination of the need for an exchange transfusion in a very-low-birth-weight infant and is a confirmation of the experience of others for the use of SnMP in reducing bilirubin production.