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Chapter 12 - Approach to the Thrombocytopenic Neonate

from Section IV - Platelet Disorders

Published online by Cambridge University Press:  30 January 2021

Pedro A. de Alarcón
Affiliation:
University of Illinois College of Medicine
Eric J. Werner
Affiliation:
Children's Hospital of the King's Daughters
Robert D. Christensen
Affiliation:
University of Utah
Martha C. Sola-Visner
Affiliation:
Harvard University, Massachusetts
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Summary

Over the last decades, as the survival of neonates admitted to the neonatal intensive care unit (NICU) improved, thrombocytopenia became an increasingly important problem in the care of sick term and particularly preterm neonates. In this population, the majority of thrombocytopenias are due to acquired processes, and most resolve with time and/or treatment of the underlying illness. Frequently, however, the etiology of the thrombocytopenia poses a diagnostic dilemma, and – if severe enough – may place the affected neonate at risk of bleeding.

Type
Chapter
Information
Neonatal Hematology
Pathogenesis, Diagnosis, and Management of Hematologic Problems
, pp. 201 - 209
Publisher: Cambridge University Press
Print publication year: 2021

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References

Aballi, AJ, Puapondh, Y, Desposito, F. Platelet counts in thriving premature infants. Pediatrics 1968;42(4):685–9.Google Scholar
Ablin, AR, Kushner, JH, Murphy, A, Zippin, C. Platelet enumeration in the neonatal period. Pediatrics 1961;28:822–4.Google Scholar
Sell, EJ, Corrigan, JJ, Jr. Platelet counts, fibrinogen concentrations, and factor V and factor VIII levels in healthy infants according to gestational age. J Pediatr 1973;82(6):1028–32.CrossRefGoogle ScholarPubMed
Wiedmeier, SE, Henry, E, Sola-Visner, MC, Christensen, RD. Platelet reference ranges for neonates, defined using data from over 47,000 patients in a multihospital healthcare system. J Perinatol 2009;29(2):130–6.CrossRefGoogle Scholar
McPherson, RJ, Juul, S. Patterns of thrombocytosis and thrombocytopenia in hospitalized neonates. J Perinatol 2005;25(3):166–72.Google Scholar
Dreyfus, M, Kaplan, C, Verdy, E, et al. Frequency of immune thrombocytopenia in newborns: A prospective study. Blood 1997;89(12):4402–6.CrossRefGoogle ScholarPubMed
Uhrynowska, M, Maslanka, K, Zupanska, B. Neonatal thrombocytopenia: Incidence, serological and clinical observations. Am J Perinatol 1997;14(7):415–18.CrossRefGoogle ScholarPubMed
Castle, V, Andrew, M, Kelton, J, et al. Frequency and mechanism of neonatal thrombocytopenia. J Pediatr 1986;108(5 Pt 1):749–55.Google Scholar
Mehta, P, Vasa, R, Neumann, L, Karpatkin, M. Thrombocytopenia in the high-risk infant. J Pediatr 1980;97(5):791–4.Google Scholar
Oren, H, Irken, G, Oren, B, Olgun, N, Ozkan, H. Assessment of clinical impact and predisposing factors for neonatal thrombocytopenia. Indian J Pediatr 1994;61(5):551–8.CrossRefGoogle ScholarPubMed
Christensen, RD, Henry, E, Wiedmeier, SE, et al. Thrombocytopenia among extremely low birth weight neonates: Data from a multihospital healthcare system J Perinatol 2006;26(6):348–53.Google Scholar
Sola, MC, Slayton, WB, Rimsza, LM, et al. A neonate with severe thrombocytopenia and radio-ulnar synostosis. J Perinatol 2004;24(8):528–30.CrossRefGoogle ScholarPubMed
Tighe, P, Rimsza, LM, Christensen, RD, Lew, J, Sola, MC. Severe thrombocytopenia in a neonate with congenital HIV infection. J Pediatr 2005;146(3):408–13.Google Scholar
Saxonhouse, MA, Manco-Johnson, MJ. The evaluation and management of neonatal coagulation disorders. Semin Perinatol 2009;33(1):5265.Google Scholar
Kaushansky, K. Lineage-specific hematopoietic growth factors. N Engl J Med 2006;354(19):2034–45.Google Scholar
Dame, C. Thrombopoietin in thrombocytopenias of childhood. Semin Thromb Hemost 2001;27(3):215–28.CrossRefGoogle ScholarPubMed
Murray, NA, Roberts, IA. Circulating megakaryocytes and their progenitors (BFU-MK and CFU-MK) in term and pre-term neonates. Br J Haematol 1995;89(1):41–6.Google Scholar
Murray, NA, Roberts, IA. Circulating megakaryocytes and their progenitors in early thrombocytopenia in preterm neonates. Pediatr Res 1996;40(1):112–19.Google Scholar
Ault, KA, Knowles, C. In vivo biotinylation demonstrates that reticulated platelets are the youngest platelets in circulation. Exp Hematol 1995;23(9):9961001.Google Scholar
Ault, KA, Rinder, HM, Mitchell, J, et al. The significance of platelets with increased RNA content (reticulated platelets). A measure of the rate of thrombopoiesis. Am J Clin Path 1992;98(6):637–46.Google Scholar
Joseph, MA, Adams, D, Maragos, J, Saving, KL. Flow cytometry of neonatal platelet RNA. J Pediatr Hematol Oncol 1996;18(3):277–81.CrossRefGoogle ScholarPubMed
Peterec, SM, Brennan, SA, Rinder, HM, Wnek, JL, Beardsley, DS. Reticulated platelet values in normal and thrombocytopenic neonates. J Pediatr 1996;129(2):269–74.Google Scholar
Saxonhouse, MA, Sola, MC, Pastos, KM, et al. Reticulated platelet percentages in term and preterm neonates. J Pediatr Hematol Oncol 2004;26(12):797802.Google Scholar
Jilma-Stohlawetz, P, Homoncik, M, Jilma, B, et al. High levels of reticulated platelets and thrombopoietin characterize fetal thrombopoiesis. Br J Haematol 2001;112(2):466–8.Google Scholar
Briggs, C, Kunka, S, Hart, D, Oguni, S, Machin, SJ. Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. Br J Haematol 2004;126(1):93–9.CrossRefGoogle ScholarPubMed
Cremer, M, Paetzold, J, Schmalisch, G, et al. Immature platelet fraction as novel laboratory parameter predicting the course of neonatal thrombocytopenia. Br J Haematol 2009;144(4):619–21.Google Scholar
Ko, YJ, Hur, M, Kim, H, et al. Reference interval for immature platelet fraction on Sysmex XN hematology analyzer: A comparison study with Sysmex XE-2100. Clin Chem Lab Med 2015;53(7):1091–7.Google Scholar
Cremer, M, Weimann, A, Szekessy, D, et al. Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis. J Perinatol 2013;33(8):622–6.Google Scholar
MacQueen, BC, Christensen, RD, Henry, E, et al. The immature platelet fraction: Creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias. J Perinatol 2017;37(7):834–8.Google Scholar
Josephson, CD, Su, LL, Christensen, RD, et al. Platelet transfusion practices among neonatologists in the United States and Canada: Results of a survey. Pediatrics 2009;123(1):278–85.CrossRefGoogle ScholarPubMed
Cremer, M, Sola-Visner, M, Roll, S, et al. Platelet transfusions in neonates: Practices in the United States vary significantly from those in Austria, Germany, and Switzerland. Transfusion 2011;51(12):2634–41.Google Scholar
Kahn, DJ, Richardson, DK, Billett, HH. Inter-NICU variation in rates and management of thrombocytopenia among very low birth-weight infants. J Perinatol 2003;23(4):312–16.Google Scholar
Del Vecchio, A, Sola, MC, Theriaque, DW, et al. Platelet transfusions in the neonatal intensive care unit: Factors predicting which patients will require multiple transfusions. Transfusion 2001;41(6):803–8.Google Scholar
Garcia, MG, Duenas, E, Sola, MC, et al. Epidemiologic and outcome studies of patients who received platelet transfusions in the neonatal intensive care unit. J Perinatol 2001;21(7):415–20.CrossRefGoogle ScholarPubMed
Murray, NA, Howarth, LJ, McCloy, MP, Letsky, EA, Roberts, IA. Platelet transfusion in the management of severe thrombocytopenia in neonatal intensive care unit patients. Transfus Med 2002;12(1):3541.CrossRefGoogle ScholarPubMed
Andrew, M, Vegh, P, Caco, C, et al. A randomized, controlled trial of platelet transfusions in thrombocytopenic premature infants. J Pediatr 1993;123(2):285–91.Google Scholar
Curley, A, Stanworth, SJ, Willoughby, K, et al. Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med 2019;380(3):242–51.Google Scholar
Stanworth, SJ, Clarke, P, Watts, T, et al. Prospective, observational study of outcomes in neonates with severe thrombocytopenia. Pediatrics 2009;124(5):e826–34.Google Scholar
Sparger, KA, Assmann, SF, Granger, S, et al. Platelet transfusion practices among very-low-birth-weight infants. JAMA Pediatr 2016;170(7):687–94.Google Scholar
von Lindern, JS, van den Bruele, T, Lopriore, E, Walther, FJ. Thrombocytopenia in neonates and the risk of intraventricular hemorrhage: A retrospective cohort study. BMC Pediatr 2011;11:16.Google Scholar
von Lindern, JS, Hulzebos, CV, Bos, AF, et al. Thrombocytopaenia and intraventricular haemorrhage in very premature infants: A tale of two cities. Arch Dis Child Fetal Neonatal Ed 2012;97(5):F348–52.Google Scholar
Sparger, K, Deschmann, E, Sola-Visner, M. Platelet transfusions in the neonatal intensive care unit. Clin Perinatol 2015;42(3):613–23.Google Scholar
Baer, VL, Lambert, DK, Henry, E, et al. Do platelet transfusions in the NICU adversely affect survival? Analysis of 1600 thrombocytopenic neonates in a multihospital healthcare system. J Perinatol 2007;27(12):790–6.Google Scholar
Kenton, AB, Hegemier, S, Smith, EO, et al. Platelet transfusions in infants with necrotizing enterocolitis do not lower mortality but may increase morbidity. J Perinatol 2005;25(3):173–7.Google Scholar
Patel, RM, Josephson, CD, Shenvi, N, et al. Platelet transfusions and mortality in necrotizing enterocolitis. Transfusion 2018;59(3):981–8.Google Scholar
Ferrer-Marin, F, Chavda, C, Lampa, M, et al. Effects of in vitro adult platelet transfusions on neonatal hemostasis. Thromb Haemost 2011;9(5):1020–8.Google ScholarPubMed
Fustolo, -Gunnink, SF, Fijnvandraat, K, van Klaveren, D, et al. Preterm neonates benefit from low prophylactic platelet transfusion threshold despite varying risk of bleeding or death. Blood. 2019;134(26):2354–60.Google Scholar
Muthukumar, P, Venkatesh, V, Curley, A, et al. Severe thrombocytopenia and patterns of bleeding in neonates: Results from a prospective observational study and implications for use of platelet transfusions. Transfus Med 2012;22(5):338–43.Google Scholar

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