Platelet count and serum thrombopoietin level as predictors for morbidity and/or mortality in thrombocytopenic neonates.

BACKGROUND

Serum thrombopoietin in thrombocytopenic infants is largely related to the cause of thrombocytopenia and the underlying disease. Many perinatal factors can affect thrombopoietin level.

PATIENTS AND METHODS

A prospective cross-sectional study on 119 thrombocytopenic neonates: 54 full term and 65 preterm had been conducted. Thrombopoietin assay was done using a qualitative enzyme-linked immunosorbent assay technique. The test was repeated on the change of clinical status (recovery or deterioration).

RESULTS

Lowering of thrombopoietin level was noted on reversal of platelet count to normal (P<0.001). Survival is significantly related to platelet count in full term (P = 0.04), but insignificant among thrombocytopenic preterms. Platelet count is negatively correlated to thrombopoietin level in neonates both in full term and preterm (r = -0.59, -0.69, respectively, P<0.001). Platelet count was found to be the best predictor for duration of recovery of thrombocytopenia in neonates compared with other factors including thrombopoietin level.

CONCLUSION

Thrombocytopenic neonates had high levels of thrombopoietin. Despite the high thrombopoietin level in neonates died with severe thrombocytopenia, yet, mortality is related to the cause and outcome of thrombocytopenia rather than the serum thrombopoietin level. It is recommended to diagnose and treat the underlying cause of thrombocytopenia rather than to generalize the therapy based on thrombopoietin level.