Sanjeev Khera1, Rakesh Gupta2. 1. Graded Specialist (Paediatrics), Military Hospital, Danapur, C/o 56 APO. 2. Associate Professor, Department of Paediatrics, AFMC, Pune - 40.
Abstract
BACKGROUND: Thrombocytopenia has not been conclusively reported as a complication of phototherapy in any of the standard paediatric textbooks. MATERIALS AND METHOD: A prospective study in consecutively enrolled cohort of apparently healthy neonates, who developed indirect hyperbilirubinaemia and required phototherapy. Neonates having a base line platelet count of more than 150,000/mm(3) were included. Neonates having features suggestive of haemolysis, direct hyperbilirubinaemia, sepsis, anti-platelet drugs given to baby or mother, haemangioma, and other congenital anomalies were excluded. Platelet counts were performed at admission, 24 hours, 48 hours, and before discontinuing phototherapy. RESULTS: Out of 100 neonates included in study 35 (35%) had thrombocytopenia and a majority of neonates had mild thrombocytopenia (74%). The thrombocytopenia was seen in 26 (74%) cases during the first 24 hours of phototherapy and usually was not associated with clinical bleed. CONCLUSION: This study establishes an association of phototherapy as a cause of thrombocytopenia in hyperbilirubinaemic neonates. Though the incidence of thrombocytopenia is substantial yet it is clinically insignificant. This study helps the practitioner to be aware of this association and avoid unnecessary investigations, as thrombocytopenia was transient.
BACKGROUND:Thrombocytopenia has not been conclusively reported as a complication of phototherapy in any of the standard paediatric textbooks. MATERIALS AND METHOD: A prospective study in consecutively enrolled cohort of apparently healthy neonates, who developed indirect hyperbilirubinaemia and required phototherapy. Neonates having a base line platelet count of more than 150,000/mm(3) were included. Neonates having features suggestive of haemolysis, direct hyperbilirubinaemia, sepsis, anti-platelet drugs given to baby or mother, haemangioma, and other congenital anomalies were excluded. Platelet counts were performed at admission, 24 hours, 48 hours, and before discontinuing phototherapy. RESULTS: Out of 100 neonates included in study 35 (35%) had thrombocytopenia and a majority of neonates had mild thrombocytopenia (74%). The thrombocytopenia was seen in 26 (74%) cases during the first 24 hours of phototherapy and usually was not associated with clinical bleed. CONCLUSION: This study establishes an association of phototherapy as a cause of thrombocytopenia in hyperbilirubinaemic neonates. Though the incidence of thrombocytopenia is substantial yet it is clinically insignificant. This study helps the practitioner to be aware of this association and avoid unnecessary investigations, as thrombocytopenia was transient.
Authors: H M Maurer; M Fratkin; N B McWilliams; B Kirkpatrick; D Draper; J C Haggins; C R Hunter Journal: Pediatrics Date: 1976-04 Impact factor: 7.124