ABSTRACT
We measured Thrombopoietin (Tpo) levels in thrombocytopenic term and preterm babies
with infection to investigate the relationship between thrombopietin levels and platelet
counts. Sixteen preterm (27-34 weeks' gestational age) and 5 term neonates (38-41
weeks' gestational age) with the diagnosis of neonatal infection and thrombocytopenia
(platelets <150 × 109/L) but, without the evidence of disseminated intravascular coagulation, were prospectively
enrolled in the study. Fifteen preterm (27-34 weeks' gestational age) and 9 term (38-40
weeks' gestational age) age-matched healthy neonates were enrolled in the study as
control. Blood samples were obtained from each subject at the time when infection
and thrombocytopenia were detected and stored until assay. Bacterial infection was
confirmed by blood cultures in five patients and by tracheal cultures in five. Median
Tpo levels of term controls were lower than those of preterm controls (62 pg/mL vs.
87 pg/mL) (p <0.05). Median Tpo levels of thrombocyopenic preterm patients were higher than the
levels of healthy preterms (258 pg/mL vs. 87 pg/mL) (p <0.05). Similarly, median Tpo levels of sick terms were significantly higher than
those of healthy term controls (209 pg/mL vs. 62 pg/mL) (p <0.001). There was not significant difference between the median Tpo levels of term
and preterm babies with infection (258 pg/mL vs. 209 pg/mL) (p >0.05). There was no correlation between platelet counts and Tpo levels in both term
and preterm groups. The results of our study show that healthy term and preterm babies
have detectable levels of Tpo and preterm babies have higher Tpo levels than term
infants. Although thrombocytopenic babies with infection have increased levels of
Tpo, these levels are still lower than the levels of thrombocytopenic children/adult
patients and there seems to be no correlation between platelet counts and thrombopoietin
levels. So our observation of increased Tpo levels may still be inadequate for normal
platelet production in this period. and this group of babies may also be candidates
for the administration of recombinant human Tpo.
KEYWORD
Thrombopoietin - thrombocytopenia - newborn
