Approach to neonatal thrombocytopenia: immature platelet fraction has a major role

Kotwal, Jyoti

doi:10.1016/s0377-1237(11)60042-7

“…Neonates presenting with thrombocytopenia were more in the late neonatal age group comprising 45 (52.9%), similar to Sonam et al study 56 (56.5%) [6], whereas other studies like Khalessi et al [11] documented 42 (67.7%) and Jeremiah et al [13] documented 112 (84.84%) thrombocytopenia cases in early neonatal age group (table 6).…”

Section: Discussionsupporting

confidence: 81%

“…Etiological profile in the present study showed 36 (42.3%) cases presenting with neonatal septicemia as the most Meena SL et al [2] and Kripa Nath Mishra et al [1]. According to Jeremiah et al [13], birth asphyxia (33.3%) was most common which is followed by jaundice (19.7%).…”

Section: Discussionmentioning

confidence: 48%

See 1 more Smart Citation

Patterns of Neonatal Thrombocytopenia with A Note on Platelet Indices and Optical Technology – A Cross-Sectional Study

Pallivilla¹,

Gudeli²,

Ledalla³

et al. 2022

Ann of Pathol and Lab Med

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Introduction: Neonatal thrombocytopenia is defined as a platelet count <150×10^9/L regardless of gestational-age. It results from hypo-proliferation in marrow or peripheral destruction of platelets. Platelet count can be rapidly measured using automated hematology analyzers, but peripheral smear remains best method. The causes of neonatal thrombocytopenia are defined by time of presentation into foetal (mainly TORCH infections), early (< 3 days), and late. The present study highlights pattern and severity of neonatal thrombocytopenia in study hospital, adding importance of platelet indices and optical technology. Aim: To study patterns and severity of neonatal thrombocytopenia, platelet indices and to measure accuracy of platelet count by optical technology methods against peripheral smear. Materials and methods: A cross-sectional study done for a period of 8 months from December 2018 to July 2019, at ASRAM medical college, Eluru. During this period blood samples of 113 critical cases of newborns, admitted with thrombocytopenia, were collected in Ethylenediamine tetra acetic acid (EDTA) vials. The platelet count was analyzed by two automated analyzers, Sysmex XN1000 and Horiba ABX Pentra XL 80. The Leishman-stained films were examined under a light microscope. ANOVA test was used to find mean difference between platelet counts, sensitivity, and specificity, and accuracy was calculated by MEDCALC CALCULATOR. Results: Out of total of 113 critical cases of new-borns admitted to Neonatal intensive care unit (NICU) at institute, 85 presented with thrombocytopenia. The variation of platelet indices was noted in 40 cases, blood cultures were collected in 77 cases. Thrombocytopenia showing platelet count less than 20,000/ mm3 is considered very severe, with 30.5% (26 cases) of total number. Elevated platelet indices were noted at 47.5%. The common clinical diagnosis was neonatal sepsis (42.3%), followed by neonatal jaundice (18.8%). The light scatterer principle of platelet evaluation proved to have better accuracy than electrical impedance, in comparison to peripheral smear findings. Conclusion: The study concludes that neonatal septicemia is major cause of neonatal thrombocytopenia as proved by correlating platelet count with platelet indices. And also, usage of automated hemogram reports with platelet indices, is a source of information to suspect etiology of thrombocytopenia thereby preventing adverse outcomes. The principle of Optical Light scatterer technique in an automated analyzer gives better results than the electrical impedance technique for detecting platelet count value, though peripheral smear examination is mandatory for confirmation.

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“…Large platelets are evidence that the bone marrow has been stimulated to produce more immature platelets in response to increased platelet consumption. 7 A study showed that MPV could be used as a simple, economical, and specific predictor for neonatal sepsis. 5 Moreover, another study found that umbilical cord and third day MPV could be examined as a substitute marker to predict early onset neonatal sepsis, and MPV was considered to be associated with mortality of preterm infants.…”

mentioning

confidence: 99%

“…This RP percentage is assessed as the immature platelet fraction (IPF). 7 Since the IPF directly detects immature platelets, it is a more accurate measure of platelet production than MPV. If the number of platelets is severely low, the laboratory machine analysis would not accurately measure the MPV value, but it would be able to measure the IPF.…”

mentioning

confidence: 99%

Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age

Septiane

¹

,

Kadi

²

,

Yuniati

³

et al. 2022

PI

0

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Background Early onset neonatal sepsis is a potential life-threatening problem for preterm infant. Diagnosing early onset neonatal sepsis is challenging. Difficulties in establishing diagnosis might cause delay definitive treatment. Objective To analyze for potential associations between early onset neonatal sepsis (EONS) risk and mean platelet volume (MPV) as well as immature platelet fraction (IPF) in neonates of 28-36 weeks gestational age. Methods A prospective cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Mean platelet volume (MPV) and IPF were evaluated in the first ?6 hours of life and during the 48-72 hours after the first examination. This examination was followed by observation for sepsis development. Double logistic regression analysis was used. Results Of 115 subjects, 45 preterm infants (39.1%) developed early onset neonatal sepsis. The increase in both mean MPV and mean IPF were significantly different (P<0.05). Double logistic regression analysis revealed that an increase in mean MPV (ORadj=6.14; 95%CI 1.99 to 18.96; P=0.002) and mean IPF (ORadj=6.56; 95%CI 2.64 to 16.34; P<0.001) were significantly associated with increased risk of sepsis. Conclusion The MPV and IPF increase are associated with greater incidence of EONS in preterm infants.

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Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age

Septiane

¹

,

Kadi²,

Yuniati³

et al. 2022

PI

0

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Background Early onset neonatal sepsis is a potential life-threatening problem for preterm infant. Diagnosing early onset neonatal sepsis is challenging. Difficulties in establishing diagnosis might cause delay definitive treatment. Objective To analyze for potential associations between early onset neonatal sepsis (EONS) risk and mean platelet volume (MPV) as well as immature platelet fraction (IPF) in neonates of 28-36 weeks gestational age. Methods A prospective cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Mean platelet volume (MPV) and IPF were evaluated in the first ?6 hours of life and during the 48-72 hours after the first examination. This examination was followed by observation for sepsis development. Double logistic regression analysis was used. Results Of 115 subjects, 45 preterm infants (39.1%) developed early onset neonatal sepsis. The increase in both mean MPV and mean IPF were significantly different (P<0.05). Double logistic regression analysis revealed that an increase in mean MPV (ORadj=6.14; 95%CI 1.99 to 18.96; P=0.002) and mean IPF (ORadj=6.56; 95%CI 2.64 to 16.34; P<0.001) were significantly associated with increased risk of sepsis. Conclusion The MPV and IPF increase are associated with greater incidence of EONS in preterm infants.

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Approach to neonatal thrombocytopenia: immature platelet fraction has a major role

Cited by 4 publications

References 12 publications

Patterns of Neonatal Thrombocytopenia with A Note on Platelet Indices and Optical Technology – A Cross-Sectional Study

Patterns of Neonatal Thrombocytopenia with A Note on Platelet Indices and Optical Technology – A Cross-Sectional Study

Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age

Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age

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