Thrombocytopenia in the Newborn Kerry Morrone, MD* *Division of Hematology Oncology & Blood and Marrow Transplantation, Children’s Hospital at Montefiore, Bronx, NY Education Gaps 1. Knowing the differential diagnosis and most likely etiologies of thrombocytopenia in the neonate will lead to more appropriate diagnostic evaluations and treatments. 2. Thrombocytopenia may be a symptom of various congenital or acquired conditions in the neonatal period and should prompt further diagnostic evaluations. Abstract Neonates develop thrombocytopenia from a multitude of causes, including immune-mediated conditions, infections, inherited disorders, and acquired conditions such as thrombosis. This can make it challenging to diagnose an underlying cause and the evaluation can be extensive. This article will provide strategies to facilitate the evaluation of thrombocytopenia in the newborn and provide a background for the underlying pathophysiology of this condition and its various causes. Objectives After completing this article, readers should be able to: 1. Provide a differential diagnosis for thrombocytopenia in the nursery or NICU. 2. Discuss the management of thrombocytopenia in the neonate. 3. Explain the differences between thrombopoiesis in the neonate compared with older children. 4. Describe the difference between neonatal autoimmune and alloimmune thrombocytopenia. 5. Discuss acquired conditions of thrombocytopenia (eg, disseminated intravascular coagulopathy, thrombosis). 6. Provide a differential diagnosis of inherited forms of neonatal thrombocytopenia. AUTHOR DISCLOSURE Dr Morrone has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. ABBREVIATIONS CAMT congenital amegakaryocytic thrombocytopenia DIC disseminated intravascular coagulation HPA human platelet antigen ICH intracranial hemorrhage IVIG intravenous immunoglobulin NAIT neonatal alloimmune thrombocytopenia NEC necrotizing enterocolitis TAR thrombocytopenia–absent radii WAS Wiskott-Aldrich syndrome XLT X-linked thrombocytopenia e34 NeoReviews by guest on January 19, 2019 http://neoreviews.aappublications.org/ Downloaded from
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Thrombocytopenia in the NewbornKerry Morrone, MD*
*Division of Hematology Oncology & Blood and Marrow Transplantation,
Children’s Hospital at Montefiore, Bronx, NY
Education Gaps
1. Knowing the differential diagnosis and most likely etiologies of
thrombocytopenia in the neonatewill lead tomore appropriate diagnostic
evaluations and treatments.
2. Thrombocytopenia may be a symptom of various congenital or acquired
conditions in the neonatal period and should prompt further diagnostic
evaluations.
Abstract
Neonates develop thrombocytopenia from a multitude of causes,
including immune-mediated conditions, infections, inherited disorders,
and acquired conditions such as thrombosis. This can make it challenging
to diagnose an underlying cause and the evaluation can be extensive.
This article will provide strategies to facilitate the evaluation of
thrombocytopenia in the newborn and provide a background for the
underlying pathophysiology of this condition and its various causes.
Objectives After completing this article, readers should be able to:
1. Provide a differential diagnosis for thrombocytopenia in the nursery
or NICU.
2. Discuss the management of thrombocytopenia in the neonate.
3. Explain the differences between thrombopoiesis in the neonate compared
with older children.
4. Describe the difference between neonatal autoimmune and alloimmune
thrombocytopenia.
5. Discuss acquired conditions of thrombocytopenia (eg, disseminated
intravascular coagulopathy, thrombosis).
6. Provide a differential diagnosis of inherited forms of neonatal
thrombocytopenia.
AUTHOR DISCLOSURE Dr Morrone hasdisclosed no financial relationships relevant tothis article. This commentary does not containa discussion of an unapproved/investigativeuse of a commercial product/device.
ABBREVIATIONS
CAMT congenital amegakaryocytic
thrombocytopenia
DIC disseminated intravascular
coagulation
HPA human platelet antigen
ICH intracranial hemorrhage
IVIG intravenous immunoglobulin
NAIT neonatal alloimmune
thrombocytopenia
NEC necrotizing enterocolitis
TAR thrombocytopenia–absent radii
WAS Wiskott-Aldrich syndrome
XLT X-linked thrombocytopenia
e34 NeoReviews by guest on January 19, 2019http://neoreviews.aappublications.org/Downloaded from
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