Etiology and outcome of thrombocytopenia in sick neonates

ABSTRACT

Enlist risk factors of thrombocytopenia in sick neonates and determine the outcome in sick neonates with thrombocytopenia in relation to risks factors. This descriptive case series study was conducted for a period of 6 months from 2007 to August 2007 in Pediatric Unit-TI, Nishtar Hospital, Multan. A total of 100 sick neonates with thrombocytopenia were included in the study. Neonates with different risks factors were evaluated which were of neonatal infection, birth asphyxia, prematurity, RDS, NEC and others [jaundice, infant of diabetic mother]. Among 100 cases with thrombocytopenia [platelets count< 150,000/ul] were included in this study, Out of 100 cases 35 [35%] were found to have early onset thrombocytopenia and 65cases [65%] were found to have late onset thrombocytopenia. Out of 100 cases, 43 cases were neonatal infection with thrombocytopenia, 23 [67.4%] were with early onset sepsis and 20 cases [46.5%] were late onset sepsis. Out of 100 cases, 17 [17%] cases were of birth asphyxia,11 cases were prematurity with birth weight <2.5 kg and gestational age <37 weeks, 6 cases of prematurity [54.5%] were with hemorrhage skin manifestation and remaining were occult mild thrombocytopenia, 20 cases of RDS with thrombocytopenia, 5 cases with NEC with thrombocytopenia and 4 cases with mild thrombocytopenia. The common manifestations in thrombocytopenic cases were petechiae and bruises followed by gastrointestinal hemorrhages. The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, prematurity, RDS, NEC. Apart from the platelets counts the bleeding manifestations also depend upon underlying ailments