Polycythaemia in the Newborn

ABSTRACT

Background: Polycythaemia; or erythrocytosis; is a condition in which there is a net increase in the total number of circulating red blood cells in the body. It is an important clinical problem in the newborn. It is relatively rare with an incidence of 1-5in the total newborn population. It may manifest with serious and sometimes life threatening insults to the brain; heart; kidneys; lungs and intestines. It requires prompt treatment to prevent serious immediate complications; including death and permanent neurologic impairment.n Aim: To highlight the clinical features and management of polycythaemia in the newborn. Case report A 9-hour-old male term; appropriate for gestational age neonate presented to the Children's Emergency Ward of the University of Port Harcourt Teaching Hospital with a history of seizures. The patient was febrile; plethoric; in respiratory distress with central and peripheral cyanosis and had repeated seizures. He had a packed cell volume of 81; thrombocytopaenia; hypoglycaemia and hypocalcaemia. He was treated with a partial exchange transfusion using normal saline. Electrolyte and metabolic derangements were also corrected. He recovered uneventfully and is currently being followed up in the Out Patient Clinic. Conclusion: Neonatal polycythaemia though uncommon; contributes to significant long and short term morbidity if untreated. Partial exchange transfusion is the treatment of choice and minimizes some of the physiologic complications