Incidence of thrombocytopenia in neonates receiving phototherapy for indirect hyperbilirubinemia: a prospective cohort study

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in the standard literature but was described briefly as isolated case reports after the phototherapy came in vogue in 1958. The purpose of this study was to find the incidence of thrombocytopenia in neonates with uncomplicated indirect hyperbilirubinemia receiving phototherapy in a referral hospital.Methods: This was a prospective cohort study conducted in a referral hospital over a period of 18 months from June 1, 2013 to November 1, 2014.Results: A total of 103 babies were enrolled. The overall incidence of post-phototherapy thrombocytopenia was 45.6% while mild, moderate and severe thrombocytopenia was present in 66%, 21.3% and 12.8% of babies respectively. The lowest platelet count observed was 31,000/mm3 but none of the neonates showed bleeding manifestations. The incidence of thrombocytopenia following phototherapy was significantly higher in preterm babies, infants who received double surface phototherapy, babies who received phototherapy for >72 hours and in babies who received phototherapy on day 2 or 3 of life.Conclusions: Neonates requiring phototherapy for hyperbilirubinemia are at risk of developing thrombocytopenia, hence the treatment should be initiated based on the standard guidelines. Unnecessary use and prolongation of phototherapy should be avoided considering the possible side effects. Platelet count should be monitored particularly in pre-term neonates receiving phototherapy. Neonates receiving double surface phototherapy and those requiring phototherapy for longer duration require more frequent platelet count monitoring.

Download Full-text

Effect of Conventional Phototherapy on platelet count in full term and Preterm Neonates with Indirect Hyperbilirubinemia - A Prospective Cohort Study

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i3.160 ◽

2018 ◽

Vol 6 (3) ◽

Author(s):

Prashant Sonawan ◽

Keyword(s):

Cohort Study ◽

Platelet Count ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Full Term ◽

Preterm Neonates

Download Full-text

Mortality rate and associated factors among preterm babies born in Moshi, north – Tanzania: A prospective cohort study

10.21203/rs.2.12403/v1 ◽

2019 ◽

Author(s):

Rose Chengo ◽

Frida Mowo ◽

Clifford Silver Tarimo ◽

Michael Johnson Mahande

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Associated Factors ◽

Neonatal Mortality Rate ◽

Live Births ◽

Extremely Preterm ◽

Preterm Babies

Abstract Introduction Globally, approximately 15 million babies are born before term each year. Of these, more than 1 million die within the first 28 days of their life. Understanding the mortality rate and its predictors during neonatal period among preterm babies is crucial to help designing interventions to avert the situation. This study aimed to determine the neonatal mortality rate and associated factors among preterm babies born in Moshi Municipality, Tanzania. Methodology A prospective cohort study was conducted in three hospitals in Moshi Municipality from December 2016 to May 2017. All live births at gestational age of <37 weeks and those of <24 hours were studied. Babies who died prior to gestation age assessment and those whose mother did not consent were excluded. Cox regression model was used to estimate maternal and fetal factors associated with neonatal mortality. A p-value of <0.05 was considered statistically significant. Results A total of 311 of preterm babies were recruited from 265 mothers and were followed for 28 days. The neonatal mortality rate was 6.5deaths per 1,000 preterm live births (95% CI: 4.83-8.61). It was higher among extremely preterm babies compared to very preterm ones (HR: 38.24; 95% CI: 16.62-87.96) versus (HR: 8.01; 95% CI: 3.96-16.20) respectively. Apgar score of <7 at 1st minute (HR: 14.03; 95% CI: 7.27-27.06), respiratory distress syndrome (HR: 8.14; 95% CI: 4.27-15.54) and antepartum hemorrhage (HR: 3.32; 95% CI: 1.49-7.39) were significantly associated with neonatal mortality. Conclusion Preterm birth complication is the major cause of neonatal death in the study setting. Interventions to address the identified risk factors may reduce neonatal mortality among preterm babies.

Download Full-text

Neurodevelopmental outcomes of preterm babies during infancy in Eastern Uganda: a prospective cohort study

Global Health Action ◽

10.1080/16549716.2020.1820714 ◽

2020 ◽

Vol 13 (1) ◽

pp. 1820714

Author(s):

Gertrude Namazzi ◽

James K. Tumwine ◽

Helena Hildenwall ◽

Grace Ndeezi ◽

Paul Mubiri ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Neurodevelopmental Outcomes ◽

Preterm Babies ◽

Eastern Uganda

Download Full-text

Methylen Blue Photoinactivated Plasma vs Fresh Frozen Plasma in Thrombotic Thrombocytopenic Purpura Treatment: A Multicentric Prospective Cohort Study.

Blood ◽

10.1182/blood.v110.11.1318.1318 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1318-1318

Author(s):

Alberto Alvarez-Larrán ◽

Julio Del Río-Garma ◽

Javier de la Rubia ◽

Concepción Zamora ◽

Antonio Galmés ◽

...

Keyword(s):

Cohort Study ◽

Platelet Count ◽

Thrombotic Thrombocytopenic Purpura ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Fresh Frozen Plasma ◽

Treatment Schedule ◽

Thrombocytopenic Purpura ◽

Fresh Frozen ◽

Frozen Plasma

Abstract Plasma exchange (PE) with plasma infusion is the treatment of choice for Thrombotic Thrombocytopenic Purpura (TTP) but doubts remain as to whether all kinds of plasma are equally effective. Since October 2004, a multicentric prospective cohort study is being conducted in Spain to compare Methylene Blue Photoinactivated Plasma (MBPIP) with Fresh Frozen Plasma (FFP) in the treatment of TTP. Sixty-three first episodes of idiopathic TTP were included. MBPIP was used in 38 and FFP in 25. The treatment schedule consisted of daily PE (> 40 mL/kg of body weight) and costicosteroids (1.5 mg/kg/d). Response was defined as the achievement of a platelet count >= 150 x 109/L for at least three consecutive days, normal LDH level and absence of TTP-related symptoms and signs. Recurrence was defined as a fall in platelet count below 50 x 109/L or below 50% of the highest count achieved after response. Response lasting for more than 15 days was considered as remission. The prognostic significance of the kind of plasma used was investigated by logistic regression analysis after adjustment for other variables that had previously been found to influence on response to PE (gender; the Rock score; days from first medical attendance to PE; volume of plasma infused in the first 7 days of treatment). Both groups were comparable with regard to clinical and biological parameters at diagnosis. A severe deficit in ADAMTS13 activity was found in 9 out 12 (75%) patients treated with MBPIP and in 12 out of 16 (75%) patients treated with FFP. When compared to FFP, patients treated with MBPIP required a higher number of PEs (16±13 vs 9±7, p=0.004) and a larger volume of plasma (763±678 ml/kg vs 413±326 ml/kg, p=0.02) to achieve a remission and presented more recurrences while on PE treatment (21 out of 38 vs 6 out of 25, p=0.02). Splenectomy or rituximab was required in eight patients (21%) treated with MBPIP to achieve a remission vs in none out of the 25 patients treated with FFP (p= 0.02). After adjustment for other prognostic variables, patients in the MBPIP group had a lower likelihood of remission by the 8th treatment day (OR: 5.1; 95% CI: 1.6 – 15.9) and a higher risk of recurrence while on PE treatment (OR: 4.2; 95% CI: 1.3 – 13.5). In conclusion, MBPIP is less effective than FFP in the treatment of TTP.

Download Full-text

Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data

British Journal of General Practice ◽

10.3399/bjgp17x691109 ◽

2017 ◽

Vol 67 (659) ◽

pp. e405-e413 ◽

Cited By ~ 38

Author(s):

Sarah ER Bailey ◽

Obioha C Ukoumunne ◽

Elizabeth A Shephard ◽

Willie Hamilton

Keyword(s):

Colorectal Cancer ◽

Primary Care ◽

Cohort Study ◽

Platelet Count ◽

Prospective Cohort Study ◽

Cancer Incidence ◽

Prospective Cohort ◽

Risk Marker ◽

Incidence Of Cancer ◽

Underlying Malignancy

BackgroundThrombocytosis (raised platelet count) is an emerging risk marker of cancer, but the association has not been fully explored in a primary care context.AimTo examine the incidence of cancer in a cohort of patients with thrombocytosis, to determine how clinically useful this risk marker could be in predicting an underlying malignancy.Design and settingA prospective cohort study using Clinical Practice Research Datalink data from 2000 to 2013.MethodThe 1-year incidence of cancer was compared between two cohorts: 40 000 patients aged ≥40 years with a platelet count of >400 × 109/L (thrombocytosis) and 10 000 matched patients with a normal platelet count. Sub-analyses examined the risk with change in platelet count, sex, age, and different cancer sites.ResultsA total of 1098 out of 9435 males with thrombocytosis were diagnosed with cancer (11.6%; 95% confidence interval [CI] = 11.0 to 12.3), compared with 106 of 2599 males without thrombocytosis (4.1%; 95% CI = 3.4 to 4.9). A total of 1355 out of 21 826 females with thrombocytosis developed cancer (6.2%; 95% CI = 5.9 to 6.5), compared with 119 of 5370 females without (2.2%; 95% CI = 1.8 to 2.6). The risk of cancer increased to 18.1% (95% CI = 15.9 to 20.5) for males and 10.1% (95% CI = 9.0 to 11.3) for females, when a second raised platelet count was recorded within 6 months. Lung and colorectal cancer were more commonly diagnosed with thrombocytosis. One-third of patients with thrombocytosis and lung or colorectal cancer had no other symptoms indicative of malignancy.ConclusionThrombocytosis is a risk marker of cancer in adults; 11.6% and 6.2% cancer incidence in males and females, respectively, is worthy of further investigation for underlying malignancy. These figures well exceed the National Institute for Health and Care Excellence-mandated risk threshold of 3% risk to warrant referral for suspected cancer.

Download Full-text

Preoperative platelet count and volume could not help predict PONV in women undergoing breast cancer surgery: A prospective cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2015.03.006 ◽

2015 ◽

Vol 18 ◽

pp. 128-131 ◽

Cited By ~ 1

Author(s):

E. Öbrink ◽

S. Eksborg ◽

P.-A. Lönnqvist ◽

E. Oddby-Muhrbeck ◽

J.G. Jakobsson

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Platelet Count ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Cancer Surgery ◽

Breast Cancer Surgery

Download Full-text

Association of non-malignant diseases with thrombocytosis: a prospective cohort study in general practice

British Journal of General Practice ◽

10.3399/bjgp20x713501 ◽

2020 ◽

Vol 70 (701) ◽

pp. e852-e857

Author(s):

Cansu Clarke ◽

Willie Hamilton ◽

Sarah Price ◽

Sarah ER Bailey

Keyword(s):

Primary Care ◽

Cohort Study ◽

Platelet Count ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Clinical Practice Research Datalink ◽

Malignant Diseases ◽

Normal Platelet Count ◽

Normal Platelet ◽

Significant Difference

BackgroundThrombocytosis is an excess of platelets, which is diagnosed as a platelet count >400 × 109/l. An association of thrombocytosis with undiagnosed cancer has recently been established, but the association with non-malignant disease has not been studied in primary care.AimTo examine, in English primary care, the 1-year incidence of non-malignant diseases in patients with new thrombocytosis and the incidence of pre-existing non-malignant diseases in patients who develop new thrombocytosis.Design and settingProspective cohort study using English Clinical Practice Research Datalink data from 2000 to 2013.MethodNewly incident and pre-existing rates of non-malignant diseases associated with thrombocytosis were compared between patients with thrombocytosis and age- and sex-matched patients with a normal platelet count. Fifteen candidate non-malignant diseases were identified from literature searches.ResultsIn the thrombocytosis cohort of 39 850 patients, 4579 (11.5%) were newly diagnosed with any one of the candidate diseases, compared with 443 out of 9684 patients (4.6%) in the normal platelet count cohort (relative risk [RR] 2.5, 95% confidence intervals [CI] = 2.3 to 2.8); iron-deficiency anaemia was the most common new diagnosis (4.5% of patients with thrombocytosis, RR 4.9, 95% CI = 4.0 to 6.1). A total of 22 612 (57.0%) patients with thrombocytosis had a pre-existing non-malignant diagnosis compared with 4846 patients (50%) in the normal platelet count cohort (odds ratio 1.3, 95% CI = 1.2 to 1.4). There was no statistically significant difference in cancer diagnoses between patients with and without pre-existing disease in the thrombocytosis cohort.ConclusionThrombocytosis is associated with several non-malignant diseases. Clinicians can use these findings as part of their holistic diagnostic approach to help guide further investigations and management of patients with thrombocytosis.

Download Full-text