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新生儿颅内出血与自身免疫性血小板减少症:一种罕见的“不可预测”事件

Intracranial Hemorrhage and Autoimmune Thrombocytopenia in a Neonate: A Rare "Unpredictable" Event.

作者信息

Becocci Andrea, Felice-Civitillo Cristina, Laurent Méryle, Boehlen Françoise, De Luca Roberta, Fluss Joel

机构信息

Neonatology and Intensive Care Unit, University Hospitals of Geneva, Geneva, Switzerland.

Pediatric Radiology Unit, University Hospitals of Geneva, Geneva, Switzerland.

出版信息

Child Neurol Open. 2018 Apr 5;5:2329048X18768693. doi: 10.1177/2329048X18768693. eCollection 2018.

Abstract

Neonatal thrombocytopenia is a rare complication of maternal autoimmune thrombocytopenia, and no maternal predictors of its gravity and potential complications have been identified. Neonatal cerebral hemorrhage, a feared event in the setting of autoimmune thrombocytopenia, is fortunately uncommon, but it can occur in utero or in the perinatal period, with potentially serious consequences. The authors report the case of a boy born to a mother affected by autoimmune thrombocytopenia, who presented with severe thrombocytopenia at birth and developed intracranial hemorrhage despite mild maternal thrombocytopenia at delivery and a prompt preventive treatment of the newborn. Platelet count should be tested at birth in all babies born from mothers with autoimmune thrombocytopenia, irrespective of maternal platelets counts during pregnancy or at delivery, and should be closely monitored during the first days of life. Systematic early and serial cranial ultrasound might be advocated in the setting of neonatal thrombocytopenia.

摘要

新生儿血小板减少症是母亲自身免疫性血小板减少症的一种罕见并发症,目前尚未发现能够预测其严重程度和潜在并发症的母亲相关因素。新生儿脑出血是自身免疫性血小板减少症情况下令人担忧的事件,幸运的是并不常见,但可发生在子宫内或围产期,可能产生严重后果。作者报告了一例母亲患有自身免疫性血小板减少症的男婴病例,该男婴出生时出现严重血小板减少症,尽管母亲分娩时血小板减少程度较轻且对新生儿进行了及时的预防性治疗,但仍发生了颅内出血。对于所有母亲患有自身免疫性血小板减少症的婴儿,无论孕期或分娩时母亲的血小板计数如何,均应在出生时检测血小板计数,并在出生后的头几天进行密切监测。在新生儿血小板减少症的情况下,可能提倡进行系统性早期和系列头颅超声检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c536/5894894/533b1d311afd/10.1177_2329048X18768693-fig1.jpg

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