J. Alallah, Faisal Yonbawi, Yousef H Qari, Abdulaziz A Abu Alnasr, H. Kandil
Neonatal seizures are prevalent in premature babies and can be the earliest sign of neurological abnormalities. Seizures in newborns are clinically significant and further inquiry leading to a solid identification of the underlying disease can aid with prognosis and treatment options. We report a male neonate born at 27 + 6 weeks of gestation. An intractable seizure developed at 9 days of age. The diagnosis is confirmed based on genetic testing.
{"title":"Unusual cause of seizure in preterm infant","authors":"J. Alallah, Faisal Yonbawi, Yousef H Qari, Abdulaziz A Abu Alnasr, H. Kandil","doi":"10.4103/jcn.jcn_49_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_49_22","url":null,"abstract":"Neonatal seizures are prevalent in premature babies and can be the earliest sign of neurological abnormalities. Seizures in newborns are clinically significant and further inquiry leading to a solid identification of the underlying disease can aid with prognosis and treatment options. We report a male neonate born at 27 + 6 weeks of gestation. An intractable seizure developed at 9 days of age. The diagnosis is confirmed based on genetic testing.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"222 - 223"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43275005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Congenital thrombotic thrombocytopenic purpura (cTTP) is a thrombotic microangiopathic caused by severely reduced activity of the von Willebrand factor-cleaving protease A Disintegrin And Metalloproteinase with a Thrombospondin type 1 Motif, member 13 (ADAMTS-13), which leads to small-vessel platelet-rich thrombi, thrombocytopenia, and microangiopathic hemolytic anemia (MHA) in the absence of neutralizing antibodies. We describe a case of cTTP in a female neonate presenting initially on the 1st day of life with asymptomatic thrombocytopenia thought to be alloimmune thrombocytopenia, then progressed to severe neonatal jaundice, pallor, and MHA, in whom ADAMTS-13 levels <5%, and the anti-ADAMTS-13 antibody titer was negative confirming the diagnosis of cTTP. The patient initially received intravenous immunoglobulin infusion before documenting MHA. She received fresh frozen plasma infusions which successfully reversed the MHA (by supplying ADAMTS-13) and prevented organ damage in this patient.
{"title":"Congenital thrombotic thrombocytopenic purpura simulating alloimmune thrombocytopenia","authors":"Muneer H Albagshi, A. A. Al Omran, Heba Elhakeem","doi":"10.4103/jcn.jcn_63_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_63_22","url":null,"abstract":"Congenital thrombotic thrombocytopenic purpura (cTTP) is a thrombotic microangiopathic caused by severely reduced activity of the von Willebrand factor-cleaving protease A Disintegrin And Metalloproteinase with a Thrombospondin type 1 Motif, member 13 (ADAMTS-13), which leads to small-vessel platelet-rich thrombi, thrombocytopenia, and microangiopathic hemolytic anemia (MHA) in the absence of neutralizing antibodies. We describe a case of cTTP in a female neonate presenting initially on the 1st day of life with asymptomatic thrombocytopenia thought to be alloimmune thrombocytopenia, then progressed to severe neonatal jaundice, pallor, and MHA, in whom ADAMTS-13 levels <5%, and the anti-ADAMTS-13 antibody titer was negative confirming the diagnosis of cTTP. The patient initially received intravenous immunoglobulin infusion before documenting MHA. She received fresh frozen plasma infusions which successfully reversed the MHA (by supplying ADAMTS-13) and prevented organ damage in this patient.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"224 - 226"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43529618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Corniche Hospital, Abu Dhabi, is the largest and most advanced perinatal center in the United Arab Emirate (UAE), providing care in line with international standards within its 64-cot NICU, serving a mainly Muslim population. We share our experience on outcomes of babies born in our center at 22 weeks' gestation, below the threshold of viability. At this gestation, a senior neonatologist attends each delivery to assess the baby, offer stabilization whilst assessing the baby's response. We then looked simply at the outcomes of these births. Methods: Retrospective data was collected from June 2011 to Dec 2020 using electronic hospital records and our in-house neonatal database – a nine-and-a-half-year period. Information on all babies born between 22 + 0 to 22 + 6 weeks gestation was sought; Gestational age was calculated from last menstrual period (LMP). Results: Over a nearly 10-year period, just over 67,000 live births occurred at our center, of which 134 babies were between 22 + 0- and 22 + 6-week gestation at birth. Complete data was available in 114 babies who were assessed as alive at the onset of labor. Thirty-seven were still born and there were 77 live births, their average weight was 486 gm. Twenty-eight babies were offered comfort care, the other 49 babies were offered stabilization/resuscitation from which 20 babies were admitted to the NICU. Four babies, whose average weight was 536gms, survived to discharge. All four survivors have varying degrees of neuro-disability and chronic lung disease. Conclusion: This information may feed into the development of a framework, that supports parents and clinicians. This framework should reflect cultural, religious, and legal aspects applicable to the Middle East whilst providing direction on the care of babies born below the current definitions of viability within the region.
{"title":"Below the threshold of “Viability” - A middle east experience","authors":"B. Ofoegbu, A. Abdelshafy, Philip Simmons","doi":"10.4103/jcn.jcn_55_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_55_22","url":null,"abstract":"Background: The Corniche Hospital, Abu Dhabi, is the largest and most advanced perinatal center in the United Arab Emirate (UAE), providing care in line with international standards within its 64-cot NICU, serving a mainly Muslim population. We share our experience on outcomes of babies born in our center at 22 weeks' gestation, below the threshold of viability. At this gestation, a senior neonatologist attends each delivery to assess the baby, offer stabilization whilst assessing the baby's response. We then looked simply at the outcomes of these births. Methods: Retrospective data was collected from June 2011 to Dec 2020 using electronic hospital records and our in-house neonatal database – a nine-and-a-half-year period. Information on all babies born between 22 + 0 to 22 + 6 weeks gestation was sought; Gestational age was calculated from last menstrual period (LMP). Results: Over a nearly 10-year period, just over 67,000 live births occurred at our center, of which 134 babies were between 22 + 0- and 22 + 6-week gestation at birth. Complete data was available in 114 babies who were assessed as alive at the onset of labor. Thirty-seven were still born and there were 77 live births, their average weight was 486 gm. Twenty-eight babies were offered comfort care, the other 49 babies were offered stabilization/resuscitation from which 20 babies were admitted to the NICU. Four babies, whose average weight was 536gms, survived to discharge. All four survivors have varying degrees of neuro-disability and chronic lung disease. Conclusion: This information may feed into the development of a framework, that supports parents and clinicians. This framework should reflect cultural, religious, and legal aspects applicable to the Middle East whilst providing direction on the care of babies born below the current definitions of viability within the region.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"202 - 205"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46862480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The trade-off between home oxygen and length of stay","authors":"Briana Hernandez, S. Manzar","doi":"10.4103/jcn.jcn_71_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_71_22","url":null,"abstract":"","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"233 - 235"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43068708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aphallia, or penile agenesis, is an extremely rare congenital anomaly, resulting from the failure of the genital tubercle to develop normally during the early period of embryogenesis. We present the case of a baby born at term by normal vaginal delivery to a primi mother with an uneventful antenatal history, except for oligohydramnios detected in the third trimester. Examination of the baby revealed an absence of phallus and external urethral meatus, normally descended testes, a normal scrotum, and a normally positioned patent anal orifice. Subsequent workup of the baby by radiological studies revealed a malrotated right kidney in the midline, multicystic renal dysplasia of the left kidney, and urethral atresia.
{"title":"A rare case of aphallia associated with urethral atresia and multiple renal anomalies","authors":"M. Ahamed, K. Neethu","doi":"10.4103/jcn.jcn_82_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_82_22","url":null,"abstract":"Aphallia, or penile agenesis, is an extremely rare congenital anomaly, resulting from the failure of the genital tubercle to develop normally during the early period of embryogenesis. We present the case of a baby born at term by normal vaginal delivery to a primi mother with an uneventful antenatal history, except for oligohydramnios detected in the third trimester. Examination of the baby revealed an absence of phallus and external urethral meatus, normally descended testes, a normal scrotum, and a normally positioned patent anal orifice. Subsequent workup of the baby by radiological studies revealed a malrotated right kidney in the midline, multicystic renal dysplasia of the left kidney, and urethral atresia.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"230 - 232"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48557727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We describe a preterm infant with a peripherally inserted central catheter (PICC) placement. The PICC line was suspected to be in the persistent left superior vena cava (PLSVC), confirmed by echocardiogram. PLSVC is a rare anomaly. On routine screening, the infant was noted to have an ipsilateral intraventricular hemorrhage (IVH) postulated to be secondary to the altered retrograde blood flow through the PLSVC. No such association has been reported previously. The case presentation is followed by evidence supporting the postulated mechanism. Although the association between PLSVC and IVH could be coincidental, clinicians should be aware of the blood flow-related problem associated with PLSVC in preterm infants.
{"title":"Persistent left superior vena cava and ipsilateral intraventricular hemorrhage in a preterm infant","authors":"Adenike Karunwi, S. Manzar, Ryan Jones","doi":"10.4103/jcn.jcn_78_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_78_22","url":null,"abstract":"We describe a preterm infant with a peripherally inserted central catheter (PICC) placement. The PICC line was suspected to be in the persistent left superior vena cava (PLSVC), confirmed by echocardiogram. PLSVC is a rare anomaly. On routine screening, the infant was noted to have an ipsilateral intraventricular hemorrhage (IVH) postulated to be secondary to the altered retrograde blood flow through the PLSVC. No such association has been reported previously. The case presentation is followed by evidence supporting the postulated mechanism. Although the association between PLSVC and IVH could be coincidental, clinicians should be aware of the blood flow-related problem associated with PLSVC in preterm infants.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"227 - 229"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42738881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarhan H. Alshammari, Azzam Alqashami, Saleh Alhumud, Meshari Aladadh, S. Alsaif, K. Ali
Background: Better understanding of the clinical characteristics of ABO hemolytic disease in neonates helps optimize care. Objective: To assess the morbidity associated with ABO incompatibility. Materials and Methods: Neonates with blood groups A or B born to mothers with blood group O were studied. Need for phototherapy (PT), intensive PT, intravenous immunoglobulin (IVIG) therapy, and packed red blood cell (PRBC) transfusions was studied. Results: The O–A group accounted for 57.2% and the O–B group 42.8%. Three-hundred and seventy-nine (46%) were Direct Coomb's test (DCT) positive. Need for PT and intensive PT was significantly higher in DCT-positive infants compared to DCT-negative infants (P < 0.001). DCT-positive infants required more PRBC transfusions (5.3% vs. 0.9%, P < 0.001) and IVIG therapy (6% vs. 0.2%, P < 0.001) compared to DCT-negative infants. Sixty percent of the blood group B infants were DCT positive compared to 35% of blood group A infants (P < 0.001). Need for PT (62% vs. 39%, P < 0.001), intensive PT (17% vs. 4%, P < 0.001), and IVIG therapy (5.4% vs. 0.8%, P < 0.001) was higher in infants with blood group B. TcB measured at median age of 12 h was predictive of the need for PT (area under the receiver operator characteristic [AUROC] =0.867) and intensive PT (AUROC = 0.917). The maximum reticulocyte percentage was predictive for both the need for IVIG therapy (AUROC = 0.978) and PRBC transfusion (AUROC = 0.863). Conclusions: DCT-positive infants and infants with blood group B suffered significantly higher adverse outcomes. TcB measured at 12 h is predictive of the need for PT and intensive PT. Maximum reticulocytes count is predictive of the severity of ABO incompatibility as evidenced by the need for PRBC transfusions and IVIG therapy.
背景:更好地了解新生儿ABO溶血性疾病的临床特点有助于优化护理。目的:探讨ABO血型不合的发病率。材料与方法:对O型血母亲所生A、B型血新生儿进行研究。对光疗(PT)、强化PT、静脉免疫球蛋白(IVIG)治疗和填充红细胞(PRBC)输注的必要性进行了研究。结果:O-A组占57.2%，O-B组占42.8%。379例(46%)直接库姆氏试验(DCT)阳性。与dct阴性婴儿相比，dct阳性婴儿对PT和强化PT的需求明显更高(P < 0.001)。与dct阴性婴儿相比，dct阳性婴儿需要更多的PRBC输注(5.3% vs. 0.9%， P < 0.001)和IVIG治疗(6% vs. 0.2%， P < 0.001)。60%的B血型婴儿DCT阳性，而35%的A血型婴儿DCT阳性(P < 0.001)。b型血婴儿对PT的需求(62%对39%，P < 0.001)、强化PT(17%对4%，P < 0.001)和IVIG治疗的需求(5.4%对0.8%，P < 0.001)更高。中位年龄12 h时测量的TcB可预测对PT的需求(受者操作者特征下面积[AUROC] =0.867)和强化PT (AUROC = 0.917)。最大网织红细胞百分比预测是否需要IVIG治疗(AUROC = 0.978)和PRBC输血(AUROC = 0.863)。结论:dct阳性婴儿和B血型婴儿的不良结局明显更高。在12小时测量TcB可以预测是否需要PT和强化PT。最大网织网细胞计数可以预测ABO不相容的严重程度，这可以通过PRBC输注和IVIG治疗来证明。
{"title":"Neonatal ABO incompatibility, influence of blood group, and coomb's test on outcome","authors":"Sarhan H. Alshammari, Azzam Alqashami, Saleh Alhumud, Meshari Aladadh, S. Alsaif, K. Ali","doi":"10.4103/jcn.jcn_64_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_64_22","url":null,"abstract":"Background: Better understanding of the clinical characteristics of ABO hemolytic disease in neonates helps optimize care. Objective: To assess the morbidity associated with ABO incompatibility. Materials and Methods: Neonates with blood groups A or B born to mothers with blood group O were studied. Need for phototherapy (PT), intensive PT, intravenous immunoglobulin (IVIG) therapy, and packed red blood cell (PRBC) transfusions was studied. Results: The O–A group accounted for 57.2% and the O–B group 42.8%. Three-hundred and seventy-nine (46%) were Direct Coomb's test (DCT) positive. Need for PT and intensive PT was significantly higher in DCT-positive infants compared to DCT-negative infants (P < 0.001). DCT-positive infants required more PRBC transfusions (5.3% vs. 0.9%, P < 0.001) and IVIG therapy (6% vs. 0.2%, P < 0.001) compared to DCT-negative infants. Sixty percent of the blood group B infants were DCT positive compared to 35% of blood group A infants (P < 0.001). Need for PT (62% vs. 39%, P < 0.001), intensive PT (17% vs. 4%, P < 0.001), and IVIG therapy (5.4% vs. 0.8%, P < 0.001) was higher in infants with blood group B. TcB measured at median age of 12 h was predictive of the need for PT (area under the receiver operator characteristic [AUROC] =0.867) and intensive PT (AUROC = 0.917). The maximum reticulocyte percentage was predictive for both the need for IVIG therapy (AUROC = 0.978) and PRBC transfusion (AUROC = 0.863). Conclusions: DCT-positive infants and infants with blood group B suffered significantly higher adverse outcomes. TcB measured at 12 h is predictive of the need for PT and intensive PT. Maximum reticulocytes count is predictive of the severity of ABO incompatibility as evidenced by the need for PRBC transfusions and IVIG therapy.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"212 - 218"},"PeriodicalIF":0.2,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45271475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Arunakumar, Sujatha Ramabhatta, S. Lakshmipathy, B. Raghunandan, K. Rashmi, Dudala Kumaraswamy, P. Mol, C. Anushree
Objectives: The objective of this study is to improve the newborn and self-care practices among postnatal mothers through quality improvement techniques and to create awareness about newborn and perinatal care practices in the Mother and Child Protection (MCP) Card. Materials and Methods: The barriers to low newborn and self-care practices were identified and evaluated using fishbone analysis. An operational team was formed, and a checklist was created. A total of four Plan-Do-Study-Act (PDSA) cycles were carried out. Baseline knowledge was collected using the questionnaire from the checklist. Appropriate education and counseling regarding newborns and self-care practices were taught. A variety of measures were used during counseling. The educated mothers were recalled after 5–7 days to assess their knowledge. Results: A total of 102 postnatal mothers were enrolled in the study, and 78 were available for follow-up after 5–7 days. During all study cycles, median checklist scores increased from 38 to 57 (PDSA 1), 37 to 58 (PDSA 2), 37 to 57 (PDSA 3), and 32.5 to 56 (PDSA 4). The increase in median checklist scores in all the PDSA cycles was statistically significant (P < 0.05). The median difference in checklist score from baseline in the chronological order of PDSA cycles was 19, 21.5, 22, and 23. After educating the mothers about the MCP Card, the percentage of mothers who read the information in the MCP Card increased from <5% to 38%. Conclusion: Quality Improvement principles such as the introduction of a checklist can be successfully implemented to improve the quality of newborns and self-care practices among postnatal mothers.
{"title":"Enhancing the quality of neonatal care by improving mothers' knowledge, attitude, and practice through checklist intervention","authors":"S. Arunakumar, Sujatha Ramabhatta, S. Lakshmipathy, B. Raghunandan, K. Rashmi, Dudala Kumaraswamy, P. Mol, C. Anushree","doi":"10.4103/jcn.jcn_20_22","DOIUrl":"https://doi.org/10.4103/jcn.jcn_20_22","url":null,"abstract":"Objectives: The objective of this study is to improve the newborn and self-care practices among postnatal mothers through quality improvement techniques and to create awareness about newborn and perinatal care practices in the Mother and Child Protection (MCP) Card. Materials and Methods: The barriers to low newborn and self-care practices were identified and evaluated using fishbone analysis. An operational team was formed, and a checklist was created. A total of four Plan-Do-Study-Act (PDSA) cycles were carried out. Baseline knowledge was collected using the questionnaire from the checklist. Appropriate education and counseling regarding newborns and self-care practices were taught. A variety of measures were used during counseling. The educated mothers were recalled after 5–7 days to assess their knowledge. Results: A total of 102 postnatal mothers were enrolled in the study, and 78 were available for follow-up after 5–7 days. During all study cycles, median checklist scores increased from 38 to 57 (PDSA 1), 37 to 58 (PDSA 2), 37 to 57 (PDSA 3), and 32.5 to 56 (PDSA 4). The increase in median checklist scores in all the PDSA cycles was statistically significant (P < 0.05). The median difference in checklist score from baseline in the chronological order of PDSA cycles was 19, 21.5, 22, and 23. After educating the mothers about the MCP Card, the percentage of mothers who read the information in the MCP Card increased from <5% to 38%. Conclusion: Quality Improvement principles such as the introduction of a checklist can be successfully implemented to improve the quality of newborns and self-care practices among postnatal mothers.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"154 - 158"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45442680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Silva, V. Carvalho, F. Raposo, M. Lima, Miguel Costa
Neonatal alloimmune neutropenia (NAN) is a rare condition in neonates, with an incidence of <0.1%. It occurs when maternal antibodies against neutrophil antigens inherited from the father cross the placenta, destroying the neutrophils of the fetus and/or the newborn. We report a case of a female neonate who started exhibiting scattered petechiae over the trunk and lower limbs, a day after birth. The blood count revealed severe neutropenia and mild thrombocytopenia. Infections were excluded. Flow cytometry analysis confirmed the presence of antineutrophil immunoglobulin G antibodies in the newborn's neutrophil membrane and in the mother's serum. When screened for polymorphisms in the genes encoding for human neutrophil antigens (HNA), we identified HNA-1b and/or HNA-3a as potential causes of the mother/daughter incompatibility. Even though neutropenia is usually self-limiting, neonates with NAN are at risk of developing severe infections. Therefore, early identification of these patients can prevent serious complications.
{"title":"A case of neonatal alloimmune neutropenia with an uncommon presentation","authors":"M. Silva, V. Carvalho, F. Raposo, M. Lima, Miguel Costa","doi":"10.4103/jcn.jcn_28_21","DOIUrl":"https://doi.org/10.4103/jcn.jcn_28_21","url":null,"abstract":"Neonatal alloimmune neutropenia (NAN) is a rare condition in neonates, with an incidence of <0.1%. It occurs when maternal antibodies against neutrophil antigens inherited from the father cross the placenta, destroying the neutrophils of the fetus and/or the newborn. We report a case of a female neonate who started exhibiting scattered petechiae over the trunk and lower limbs, a day after birth. The blood count revealed severe neutropenia and mild thrombocytopenia. Infections were excluded. Flow cytometry analysis confirmed the presence of antineutrophil immunoglobulin G antibodies in the newborn's neutrophil membrane and in the mother's serum. When screened for polymorphisms in the genes encoding for human neutrophil antigens (HNA), we identified HNA-1b and/or HNA-3a as potential causes of the mother/daughter incompatibility. Even though neutropenia is usually self-limiting, neonates with NAN are at risk of developing severe infections. Therefore, early identification of these patients can prevent serious complications.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"172 - 175"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49586754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rakesh Kumar, Sanober Wasim, G. Gupta, Mansi Naithani
Peromelia is a rare condition leading to the absence of limb. Birth of such a baby is an unexpected and emotionally disturbing event for the parents, if it was not diagnosed antenatally. Family members and especially the mother at such time need proper counseling from the health-care workers during the initial days. The management aspects including prosthesis and timing of intervention need to be informed to the parents. Here, we describe a case of peromelia with emphasis on the psychological aspect of management.
{"title":"A neonate with peromelia: congenital transverse deficiency of an upper limb","authors":"Rakesh Kumar, Sanober Wasim, G. Gupta, Mansi Naithani","doi":"10.4103/jcn.jcn_146_21","DOIUrl":"https://doi.org/10.4103/jcn.jcn_146_21","url":null,"abstract":"Peromelia is a rare condition leading to the absence of limb. Birth of such a baby is an unexpected and emotionally disturbing event for the parents, if it was not diagnosed antenatally. Family members and especially the mother at such time need proper counseling from the health-care workers during the initial days. The management aspects including prosthesis and timing of intervention need to be informed to the parents. Here, we describe a case of peromelia with emphasis on the psychological aspect of management.","PeriodicalId":45332,"journal":{"name":"Journal of Clinical Neonatology","volume":"11 1","pages":"176 - 178"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47954049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：