Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants

We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older ch...

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Main Author: Ga Won Jeon
Format: Article
Language:English
Published: The Korean Pediatric Society 2022-04-01
Series:Clinical and Experimental Pediatrics
Subjects:
Online Access:http://www.e-cep.org/upload/pdf/cep-2021-00864.pdf
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author Ga Won Jeon
author_facet Ga Won Jeon
author_sort Ga Won Jeon
collection DOAJ
description We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.
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spelling doaj.art-f52888bdad5f4d0f97d458a0198c45672022-12-21T21:10:14ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482022-04-0165418218710.3345/cep.2021.0086420125555473Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infantsGa Won Jeon0 Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, KoreaWe frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.http://www.e-cep.org/upload/pdf/cep-2021-00864.pdfnewborn infantpremature infantplateletsthrombocytosisthrombopoietin
spellingShingle Ga Won Jeon
Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
Clinical and Experimental Pediatrics
newborn infant
premature infant
platelets
thrombocytosis
thrombopoietin
title Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
title_full Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
title_fullStr Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
title_full_unstemmed Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
title_short Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
title_sort pathophysiology classification and complications of common asymptomatic thrombocytosis in newborn infants
topic newborn infant
premature infant
platelets
thrombocytosis
thrombopoietin
url http://www.e-cep.org/upload/pdf/cep-2021-00864.pdf
work_keys_str_mv AT gawonjeon pathophysiologyclassificationandcomplicationsofcommonasymptomaticthrombocytosisinnewborninfants