Neonatal Thrombocytopenia

Defects in production or function: TAR Syndrome (Thrombocytopenia with Absent radius) Congenital amegakaryocytic thrombocytopenia (CAMT) Giant platelet syndrome Trisomy 13 or 18 Renal disease Increased destruction: Infection, DIC, Thrombosis Birth trauma, malignancy Cyanotic heart disease Maternal factors: Neonatal Alloimmune thrombocytopenia Pre-eclampsia Maternal medication Other causes: Rh disease Phototherapy Congential infections Neonatal polycythemia Wiskott-Aldrich Syndrome

* Check mother's platelet count

Normal: Send maternal blood for HPA (human platelet antigen) type, antiplatelet antibodies, and infant blood for HPA type. If positive likely Neonatal Alloimmune Thrombocytopenia. Follow serial platelet counts and transfuse washed maternal platelets as needed. If bleeding transfuse random donor platelets. If negative - investigate further. Low: Investigate other causes of infant's thrombocytopenia such as maternal ITP. Treatment options include IVIG and steroids. Transfuse as needed for bleeding.