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Trombocitopenia severa neonatal
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Abstract(s)
RESUMO
Introdução: A redução do número de plaquetas nas primeiras
horas de vida deve-se frequentemente a factores maternos
ou eventos perinatais. A trombocitopenia aloimune, embora
subdiagnosticada, é a causa mais frequente de trombocitopenia
severa no recém-nascido de termo saudável e resulta da destruição
imuno-mediada das plaquetas fetais/neonatais por aloanticorpos
maternos.
Caso clínico: Apresenta-se o caso de um recém-nascido
com trombocitopenia aloimune, com clínica típica e evolução favorável,
sublinhando-se o impacto positivo de um elevado índice
de suspeição e do tratamento empírico com plaquetas HPA-1a
negativas.
Conclusão: O diagnóstico atempado desta entidade permite
uma orientação terapêutica eficaz, baseada na administração
de plaquetas compatíveis, prevenindo eventuais complicações,
nomeadamente, a hemorragia intracraniana. Possibilita ainda o
planeamento da vigilância em gestações futuras do casal e o
tratamento pré-natal.
ABSTRACT Introduction: Thrombocytopenia in the first hours of life is generally due to maternal factors or perinatal events. Alloimune thrombocytopenia, although underdiagnosed, is the most frequent type of severe thrombocytopenia in a term and otherwise healthy newborn, resulting from an immune mediated destruction of foetal/neonatal platelets by maternal alloantibodies. Case report: We present the case of a newborn with alloimune thrombocytopenia, a typical clinical presentation and good outcome, highlighting the positive impact in the prognosis of a high index of suspicion and of empirical treatment with HPA-1a negative platelets. Conclusion: An early diagnosis of this entity allows effective treatment with the infusion of compatible platelets, preventing eventual complications, namely intracranial haemorrhage. Also guides the monitoring of future pregnancies and antenatal treatment.
ABSTRACT Introduction: Thrombocytopenia in the first hours of life is generally due to maternal factors or perinatal events. Alloimune thrombocytopenia, although underdiagnosed, is the most frequent type of severe thrombocytopenia in a term and otherwise healthy newborn, resulting from an immune mediated destruction of foetal/neonatal platelets by maternal alloantibodies. Case report: We present the case of a newborn with alloimune thrombocytopenia, a typical clinical presentation and good outcome, highlighting the positive impact in the prognosis of a high index of suspicion and of empirical treatment with HPA-1a negative platelets. Conclusion: An early diagnosis of this entity allows effective treatment with the infusion of compatible platelets, preventing eventual complications, namely intracranial haemorrhage. Also guides the monitoring of future pregnancies and antenatal treatment.
Description
Keywords
Plaquetas HPA-1a negativas recém-nascido de termo trombocitopenia aloimune Alloimune thrombocytopenia HPA-1a negative platelets term newborn
Citation
Nascer e Crescer 2011; 20(1): 20-22