期刊
SEMINARS IN PERINATOLOGY
卷 33, 期 1, 页码 43-51出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.semperi.2008.10.008
关键词
neonate; thrombocytopenia; megakaryocytopoiesis; sepsis; necrotizing enterocolitis; intrauterine hypoxia
资金
- NIH [HL69990]
Thrombocytopenia affects up to 35% of all patients admitted to the neonatal intensive care unit. The causes of thrombocytopenia in neonates are very diverse and include immune and nonimmune disorders. Most cases of thrombocytopenia encountered in the neonatal intensive care unit are nonimmune, and these will constitute the focus of this review. Specifically, we first discuss the biological differences between neonatal and adult megakaryocytopoiesis, which contribute to explain the vulnerability of neonates to develop thrombocytopenia. Next, we review new diagnostic tools that have allowed for a better evaluation of platelet production in neonates, without having to obtain a bone marrow sample. Finally, we summarize our current understanding of the mechanisms underlying the thrombocytopenia in several common neonatal conditions, such as chronic intrauterine hypoxia, sepsis and necrotizing enterocolitis, and viral infections. A better understanding of the mechanisms underlying these varieties of thrombocytopenia is critical to develop disease-specific treatment protocols and to begin to entertain the possibility of using novel thrombopoietic growth factors to treat selected neonates with severe thrombocytopenia.
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