Borensztajn Dorine M, Jansen Sandra, Lopriore Enrico, Boersma Bart
Medisch Centrum Alkmaar, afd. Kindergeneeskunde, Alkmaar, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1922.
Thrombocytopenia usually has a moderate course in full-term babies. Here, however, we describe two newborns with serious complications due to neonatal alloimmune thrombocytopenia. One patient was transferred to the paediatrician because of pallor, a swelling on the head and petechiae. He had a subgaleal hemorrhage. Following a platelet transfusion he made a complete recovery. The other presented with thrombocytopenia and petechiae and was treated with intravenous immunoglobulin. Several days later the patient started vomiting. Cranial ultrasound showed hydrocephalus most probably arising from an intraventricular haemorrhage following the thrombocytopenia, for which he received a ventriculoperitoneal drain. After this he made a successful recovery. Although neonatal alloimmune thrombocytopenia is a rare condition it can have serious consequences for the newborn and for subsequent pregnancies. It is important that treatment be started early and that cranial ultrasound always be performed.
血小板减少症在足月儿中通常病程较为缓和。然而，在此我们描述了两名因新生儿同种免疫性血小板减少症而出现严重并发症的新生儿。一名患儿因面色苍白、头部肿胀和瘀点被转诊至儿科医生处。他发生了帽状腱膜下出血。输注血小板后完全康复。另一名患儿表现为血小板减少症和瘀点，接受了静脉注射免疫球蛋白治疗。几天后，该患儿开始呕吐。头颅超声显示脑积水，很可能是血小板减少症后发生脑室内出血所致，为此他接受了脑室腹腔分流术。此后康复顺利。尽管新生儿同种免疫性血小板减少症是一种罕见疾病，但它可能给新生儿及后续妊娠带来严重后果。尽早开始治疗并始终进行头颅超声检查很重要。
