Platelets are cellular fragments within bone marrow and tissues that play an important role in stopping active bleeding. Neonatal thrombocytopenia refers to a low number of platelets in a baby's blood. According to the book, "Hematology: Basic Principles and Practice," having a platelet count of fewer than 150,000 cells is abnormally low. When determining the cause of thrombocytopenia, an important consideration is whether or not the baby looks healthy.
Alloimmune Condition
A healthy-looking baby is most likely to suffer from neonatal alloimmune thrombocytopenia. The problem resides with his platelets having a coating of maternal antibodies that the liver and spleen rapidly clear. This thrombocytopenia develops due to his mother not having any platelet antigen, PLA-1, and the father having some, according to "The Handbook of Neonatal Intensive Care."
Infection
According to the book "Hematolgy: Basic Principals and Practice," infection ranks high as one of the most frequent causes of a low platelet count in sick babies. Bacterial, viral and fungal infections have all been associated with neonatal thrombocytopenia. Infection causes damage to cells, and the body works hard to fix those damaged cells. Viral infections such as the TORCH infections cause reduced platelet production and accelerated platelet destruction, according to "Nelson Textbook of Pediatrics." TORCH infections refer to toxoplasmosis, parvovirus and varicella-zoster virus, rubellavirus, cytomegalovirus and herpes simplex virus. The cytomegalovirus, or CMV, causes severe thrombocytopenia.
Wiskott-Aldrich Syndrome
Wiskott-Aldrich syndrome, or WAS, is an inherited genetic disorder characterized by thrombocytopenia, small platelets, eczema and frequent infections due to this immune deficiency.
Liver Failure
Evidence of platelet dysfunction is often noted in neonates with liver disease. Liver disease can result from viral hepatitis or some rare metabolic disorders. Jaundice and high liver enzymes often accompany the failure. The affected baby would show evidence of bleeding into her skin, gastrointestinal tract and brain.
Disseminated Intravascular Coagulation
Disseminated Intravascular Coagulation, or DIC, occurs as part of a larger problem. In DIC, blood-clotting proteins are activated by bacteria or inflammation. The start of the clotting proteins leads to thromboses or a clot of coagulated blood forming in small vessels, the liver, spleen, brain and other vital organs. The body tries to compensate by releasing platelets and clotting factors, but an affected baby's system is too immature to handle the clotting proteins, leading to weak platelets and clotting factors. DIC results in bleeding into the head, skin, urine, stool, and around any tubes and catheters the baby may have attached to his body.
References
- "Hematology: Basic Principles and Practice"; Ronald Hoffman; 2008
- "Handbook of Neonatal Intensive Care"; Gerald Merenstein and Sandra Gardner; 2006
- "Nelson Textbook of Pediatrics"; Robert Kliegman; 2007
