Consultorios Privados de Hematología Infantil. Ciudad Autónoma de Buenos Aires, Argentina.
Arch Argent Pediatr. 2021 Jun;119(3):e202-e214. doi: 10.5546/aap.2021.eng.e202.
Thrombocytopenia, defined as a platelet count below 100 x 109/L, is a very common finding in the neonatal period, especially in critically ill infants and preterm newborns. Its causes are multiple: it may be due both to pediatric conditions and to other factors involved in the fetal-placental-maternal interface. This initial article describes the causes of thrombocytopenia, proposes a diagnostic approach to manage a thrombocytopenic newborn infant, and provides a detailed description of the different conditions corresponding to thrombocytopenia of immune etiology. It also describes the different causative mechanisms and reviews the varying characteristics of thrombocytopenia secondary to maternal immune thrombocytopenia and neonatal alloimmune thrombocytopenia. The different treatment approaches to each of the different conditions are described both for their pre- as well as their postnatal management. The severity of thrombocytopenia and the serious complications and sequelae associated with the neonatal alloimmune thrombocytopenia are highlighted.
血小板减少症定义为血小板计数低于 100x109/L，在新生儿期非常常见，尤其是在危重症婴儿和早产儿中。其病因很多：可能既有儿科疾病，也有胎儿-胎盘-母体界面涉及的其他因素。本文首先描述了血小板减少症的病因，提出了管理血小板减少新生儿的诊断方法，并详细描述了与免疫病因学相关的血小板减少症对应的不同情况。还描述了不同的致病机制，并回顾了与母体免疫性血小板减少症和新生儿同种免疫性血小板减少症相关的血小板减少症的不同特征。对每种情况的不同治疗方法都进行了描述，包括产前和产后管理。强调了血小板减少症的严重程度以及与新生儿同种免疫性血小板减少症相关的严重并发症和后遗症。
