A neonate was found to have a generalized petechial rash and intracranial hemorrhage immediately after delivery. His Hb is low, Platelet is 4. The mother has a normal platelet coun... A neonate was found to have a generalized petechial rash and intracranial hemorrhage immediately after delivery. His Hb is low, Platelet is 4. The mother has a normal platelet count, normal uneventful spontaneous vaginal delivery. He is the first baby for her. What is the most likely diagnosis?
Understand the Problem
The question describes a neonate with a generalized petechial rash, intracranial hemorrhage, low hemoglobin, and very low platelet count (4) immediately after delivery. The mother has a normal platelet count and an uneventful delivery, and this is her first baby. We need to determine the most likely diagnosis from the provided options.
Answer
Neonatal Alloimmune Thrombocytopenia (NAIT)
The most likely diagnosis is Neonatal Alloimmune Thrombocytopenia (NAIT). This condition occurs when the mother produces antibodies against the baby's platelets, leading to a low platelet count (thrombocytopenia) in the neonate and subsequent bleeding complications such as petechial rash and intracranial hemorrhage.
Answer for screen readers
The most likely diagnosis is Neonatal Alloimmune Thrombocytopenia (NAIT). This condition occurs when the mother produces antibodies against the baby's platelets, leading to a low platelet count (thrombocytopenia) in the neonate and subsequent bleeding complications such as petechial rash and intracranial hemorrhage.
More Information
- NAIT is caused by maternal antibodies against fetal platelets.
- It can lead to severe thrombocytopenia and intracranial hemorrhage in the newborn.
- The mother typically has a normal platelet count.
Tips
A common mistake is to confuse NAIT with other causes of thrombocytopenia. Consider the maternal history and platelet count to differentiate.
Sources
- Neonatal alloimmune thrombocytopenia - PMC - pmc.ncbi.nlm.nih.gov
- Neonatal Thrombocytopenia: Etiology and Diagnosis - PMC - pmc.ncbi.nlm.nih.gov
- Prenatal Management of 21-Year-Old Woman - Hematology.org - hematology.org
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