Risk factors for severe neonatal thrombocytopenia in cases of maternal immune thrombocytopenia.

2022 ◽  
Author(s):  
Florian Point ◽  
Louis Terriou ◽  
Thameur Rakza ◽  
Elodie Drumez ◽  
Gauthier Alluin ◽  
...  
2018 ◽  
Vol 93 (7) ◽  
pp. E181-E184 ◽  
Author(s):  
Guillaume Moulis ◽  
Johanne Germain ◽  
Thibault Comont ◽  
Amélie Arrouy ◽  
Maryse Lapeyre-Mestre ◽  
...  

2016 ◽  
Vol 50 (1) ◽  
pp. 31
Author(s):  
Nila Kusumasari ◽  
Rinawati Rohsiswatmo ◽  
Djajadiman Gatot ◽  
Darlan Darwis

Background Thrombocytopenia is the most common hematological abnormality in the neonatal period. Hemorrhagic manifestations are found in 10% cases of thrombocytopenia. Neonatal thrombocytopenia commonly assumed due to sepsis, despite many risk factors that may caused thrombocytopenia.Objective To obtain incidence and risk factors of neonatal thrombocytopenia.Methods A cross sectional study was conducted in April 2009. Complete blood counts investigation was performed before age of 24 hours, medical conditions and risk factors of mothers and subjects were noted, as well as hemorrhagic manifestations. Subjects with thrombocytopenia were followed for 2 weeks. The risk factors consisted of hypertension in pregnancy, pre-eclampsia, eclampsia, intrauterine growth retardation, gestational diabetes mellitus, perinatal infection, asphyxia, sepsis, and necrotizing enterocolitis.Results Neonatal thrombocytopenia was found 17 (12.1%) of 140 subjects, consisted of 88.2% early onset and 11.8% late onset. Significant risk factor of mother was pre-eclampsia (PR 3.97, 95%CI 1.70 to 9.25), while significant risk factors of neonates were asphyxia (PR 5.66, 95%CI 2.49 to 12.86), sepsis (PR 5.33, 95%CI 2.33-12.19) and necrotizing enterocolitis (p=0.014; PR 9.2 95% CI 5.17 to14.84). We found 29.4% hemorrhagic cases of neonatal thrombocytopenia (i.e.,. skin, gastrointestinal, intracranial hemorrhage).Conclusions The incidence of neonatal thrombocytopenia was 12.2%. Significant risk factor of mother that caused thrombocytopenia was pre-eclampsia, while risk factors of neonates were asphyxia, sepsis and necrotizing enterocolitis.[Paediatr Indones. 2010;50:31-7].


2003 ◽  
Vol 20 (1) ◽  
pp. 049-054 ◽  
Author(s):  
Mario E. Beiner ◽  
Michal J. Simchen ◽  
Eyal Sivan ◽  
Angela Chetrit ◽  
Jacob Kuint ◽  
...  

2016 ◽  
Vol 91 (12) ◽  
pp. E499-E501 ◽  
Author(s):  
Sara Melboucy‐Belkhir ◽  
Mehdi Khellaf ◽  
Alexandre Augier ◽  
Marouane Boubaya ◽  
Vincent Levy ◽  
...  

2021 ◽  
Vol 20 (3) ◽  
pp. 92-101
Author(s):  
E. V. Suntsova ◽  
M. N. Sadovskaya ◽  
O. V. Spichak ◽  
S. S. Ozerov ◽  
S. P. Khomyakova ◽  
...  

Primary immune thrombocytopenia is a benign and self-limiting process in the majority of children. Severe life-threatening hemorrhages, including intracranial, develop rarely. Risk factors predisposing for development of severe hemorrhagic complications have not been determined. In order to decrease the severity of neurological consequences and mortality in intracranial hemorrhages, timely combined urgent therapy is neсessary. There are four clinical cases of intracranial hemorrhage in immune thrombocytopenia in children with different outcomes in this article. The parents of the patients agreed to use the information, including photos of children, in scientific research and publications.


2020 ◽  
Vol 24 (3) ◽  
pp. 229-234
Author(s):  
Hira Arif ◽  
Nadeem Ikram ◽  
Shangraf Riaz ◽  
Asma Nafisa

Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi. Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia. Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia. Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-11
Author(s):  
O. A. Soboleva ◽  
K. I. Ntanisian ◽  
E. K. Egorova ◽  
A. L. Melikyan ◽  
E. G. Gemdzhian ◽  
...  

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia. Splenectomy remains an effective and safe treatment for ITP. Objective: Identify and estimate risk factors associated with no response (platelet count < 30 x 109/L) to splenectomy for adult ITP patients. Patients and Methods: The study conducted at National Research Center for Hematology (Moscow) from 03/2015 to 11/2019 included all patients (in total, 111) with ITP, who underwent laparoscopic splenectomy. Median (Med) platelet count at admission was 12 x 109/L (range from 1 to 239 x 109/L). The time from diagnosis of ITP to splenectomy varied from 3 months to 51 years. All patients had received from 1 to 3 lines of treatment prior to splenectomy. Pre-splenectomy treatment was carried out at platelet count < 20 x 109/L and/or in the presence of bleeding. Results: Of the 111 patients 31 were male (Med age 43 years [IQR 27-55]) and 80 were female (Med age 37 [IQR 29-49]). The male/female ratio was 1:2.6. Complete response to splenectomy (platelet count > 100 x 109/L) was achieved in 79/111 (71.2%) cases, 11/111 (9.9%) patients had partial response (platelet count: 30-100 x 109/L) and 21/111 (18.9%) failed to respond (platelet count < 30 x 109/L). Patients who achieved complete response to splenectomy had a significantly higher immediate pre-splenectomy platelet count than non-responders: Med platelet count (95% CI): 47 (35-58) vs 16 (9-20) (x 109/L), Mann-Whitney U test, P < 0.001 (CI, confidence interval) (Figure 1). Multivariate logistic regression analysis was carried out to identify factors associated with splenectomy outcome (response/no response). Multivariate analysis included patient's gender and age, duration of ITP, grade of bleeding at admission, platelet count at admission, preoperative platelet count and number of prior lines of therapy. Continuous variables were dichotomized using ROC analysis, in particular, cut-off point for preoperative platelet count was 23 x 109/L. As a result, following statistically significant (Wald test) factors were selected: • an unfavorable predictor: immediate pre-splenectomy platelet count < 23 x 109/L, RR (95% CI): 2.5 (1.1-8.6), P = 0.001 (RR, relative risk) (Figure 1) and • combined unfavorable risk factor: male gender in the age over 60 (compared to men in the age ≤60 and women in general), RR (95% CI): 2.0 (0.9-7.1), P = 0.05 (Figure 2). Response rate was negatively correlated (in univariate analysis) with the number of treatment lines prior to splenectomy (negative Spearman's rank correlation coefficient, −0.30; P = 0.01). When preoperative platelet count ≥ 23 x 109/L was achieved, probability of complete response to splenectomy was 80% (Figure 3). The rate of postoperative complications was 12.6%. According to our follow-up data (up to 5 years) 66/79 (83.5%) patients maintained complete response. Conclusions: High-risk groups were identified: patients with immediate pre-splenectomy platelet count < 23 x 109/L (i.e. with no effect of preoperative treatment) and men over the age of 60. Identified risk factors could be taken into account in decision-making process. Disclosures No relevant conflicts of interest to declare.


1987 ◽  
Author(s):  
M Kos ◽  
F X Hainz ◽  
I Assmann ◽  
M Kundi ◽  
I Pabinger ◽  
...  

Lymphocyte subsets, platelet counts, immune globulin levels and antibody to HIV (Elisa, WB) were determined in 87 multitransfused asymptomatic haemophiliacs in 1982/83. Between 1982 and 1987 6 patients developed AIDS and 5 ARC (3 immune thrombocytopenia and 2 lymphadenopathy). AIDS or ARC developed in seropositive patients only (11/49). Patients who subsequently developed AIDS or ARC showed significantly lower numbers of T helper lymphocytes (378/mm3 versus 605/mm3; p 0.01), lower platelet counts (157x109 versus 194x109; p 0.05) and higher levels of IgG (2528 mg/dl versus 1992 mg/dl; p 0.01). AIDS or ARC occured in 4 of 7 patients(57.1%) with a low HIV antibody level ( 2000), but only in 7 of 42 (16.6%) with a high level of antibody to HIV ( 2000). A weak gag p 24 in WB was found in 4 of 11 patients (36.3%) who subsequently acquired AIDS or ARC , while none of the patients whq remained asymptomatic displayed this reactivity pattern in WB. 9 patients showed a weak gag p 18 in WB. 8 of them (88.8%) have platelet counts below 120x109 /1, 3 developed imiruine thrombocytopenia with platelet counts of less than 50xl09. Oily 6 of 40 patients (15%) without this reactivity pattern in WB have platelet counts lower than 120x109 and none below 50xl09.We conclude that a weak gag p 24 in WB has a strong positive predictive power for the development of AIDS or ARC in seropositive haemophiliacs. A weak gag p 18 in WB could possibly be associated with the occurence of immune thrombocytopenia in these patients.


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