The deleterious effects on erythrocytes of low steady-state concentrations of H2O2 in vitro have been compared in samples from full-term and premature infants and adults. Methemoglobin and Heinz bodies were formed to a greater degree in the intact erythrocytes of the young subjects. In the absence of protective enzymes, however, the extent of oxidation was similar in hemoglobin prepared from cord blood and from adult blood, respectively. Activity of the enzymes involved in the detoxification of H2O2 has been measured in the red blood cells of the aforementioned groups of subjects. Of note was the finding of significantly decreased activity of glutathione peroxidase in the full-term newborn and premature infants. These findings of increased toxicity from H2O2 and decreased efficiency of the detoxification mechanisms are considered to have bearing on the susceptibility of young subjects to drug-induced hemolytic anemia.

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A fetus with absent radii in both forearms was discovered on routine ultrasound examination performed at 18 weeks of pregnancy. No other significant abnormalities were found, and no signs of haemorrhage were detected. Serial ultrasound examinations revealed no evidence of fetal internal bleeding. At 37 weeks of pregnancy, a CBC obtained by cordocentesis under ultrasound guidance confirmed the diagnosis of thrombocytopenia absent radii (TAR) syndrome. Apheresis platelets were transfused into the umbilical vein to correct the thrombocytopenia and was followed by an uncomplicated delivery. No bleeding was encountered during the remainder of the baby's neonatal course. We conclude that TAR syndrome can be readily identified prenatally on sonogram, and if severe thrombocytopenia is confirmed by cordocentesis, platelets should be transfused to diminish the risk of serious internal bleeding during and immediately after delivery.