Petechiae in the newborn: A sign to consider

Authors

  • Maria João Gaia Department of Pediatrics and Neonatology, Centro Hospitalar de Vila Nova de Gaia/Espinho
  • Joana Brandão Silva Department of Pediatrics and Neonatology, Centro Hospitalar de Vila Nova de Gaia/Espinho
  • Mariana Capela Department of Pediatrics and Neonatology, Centro Hospitalar de Vila Nova de Gaia/Espinho
  • Rui Pinto Department of Pediatrics and Neonatology, Centro Hospitalar de Vila Nova de Gaia/Espinho https://orcid.org/0009-0005-3239-9671

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v32.i2.25163

Keywords:

aloimune, neonatal, thrombocytopenia

Abstract

Neonatal alloimmune thrombocytopenia (NAIT) occurs when the mother develops antiplatelet antibodies against fetal platelets and is confirmed by the presence of maternal antihuman platelet antibodies.
A full-term newborn from a first pregnancy without complications was routinely examined on the first day of life. The newborn appeared well and had multiple petechiae on the axillary, inguinal, and popliteal folds and on the lower abdomen, with no other findings. Blood work revealed thrombocytopenia of 28,000/ul with a normal remaining hemogram and negative C-reactive protein. Because of the suspicion of NAIT, an intravenous dose of immunoglobulin was administered with a subsequent increase in platelet count. The diagnosis was confirmed on day 5 with the detection of maternal antiplatelet anti-HPA-1a alloantibodies.
A thorough physical examination of the newborn is essential, as some serious conditions may present with subtle changes. NAIT should be considered in the differential diagnosis of isolated petechiae of the newborn.

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References

Caraciolo JF. Neonatal immune-mediated thrombocytopenia. UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2020.

Kamphuis MM, Paridaans NP, Porcelijn L, Lopriore E, Oepkes D. Incidence and consequences of neonatal alloimmune thrombocytopenia: a systematic review. Pediatrics. 2014;133(4):715-21.

Peterson JA, McFarland JG, Curtis BR, Aster RH. Neonatal alloimmune thrombocytopenia: pathogenesis, diagnosis and management. Br J Haematol. 2013;161(1):3-14.

Mella MT, Eddleman K. Neonatal alloimmune thrombocytopenia. International Journal of Clinical Transfusion Medicine. 2015;3:29-40.

Consenso Clínico “Trombocitopenia no recém-nascido” - Sociedade Portuguesa de Neonatologia. (2013). Retrieved October 26, 2021, from https://www.spneonatologia.pt/wp-content/uploads/2016/11/2013-Trombocitopenia.pdf.

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Published

2023-09-14

How to Cite

1.
Gaia MJ, Brandão Silva J, Capela M, Pinto R. Petechiae in the newborn: A sign to consider. REVNEC [Internet]. 2023Sep.14 [cited 2024Jun.14];32(2):147-9. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/25163

Issue

Section

Imaging Cases

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