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5 - Hypoplastic anemia

Published online by Cambridge University Press:  10 August 2009

Gary Kupfer
Affiliation:
M.D. Division of Pediatric Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
Pedro A. de Alarcón
Affiliation:
University of Tennessee
Eric J. Werner
Affiliation:
Eastern Virginia Medical School
J. Lawrence Naiman
Affiliation:
Stanford University School of Medicine, California
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Summary

When a neonate presents with anemia, the first diagnostic thought of the clinician is not of a congenital aplastic disorder. Indeed, compared with adults, all newborns normally are relatively “anemic” during a window of one to two months postpartum, the so-called physiologic anemia of the newborn. Thereafter, erythropoiesis will be stimulated, and higher hemoglobin levels are achieved. However, persistence of anemia beyond this period signals a pathologic condition. When one encounters an anemic baby whose work-up reveals no evidence of hemolysis, a negative Coombs' test, and a low reticulocyte count, with or without additional cell lines depressed, then a work-up that considers the common infectious etiologies, as well as the less common genetic causes of hypoplastic anemia, must be undertaken.

Causes of cytopenias

Aside from the physiological anemias discussed in Chapter 4, any or all of the blood-cell lines in the neonate may be affected by primary or secondary causes. The clinical picture, including historical and physical findings, will provide clues as to the etiology of the cytopenias (as discussed in Chapter 3), but often only time will allow identification of the ultimate cause of the cytopenias. Table 5.1 lists the causes of hypoplastic anemia in the newborn.

Infections

Typically, congenital infections in the neonate cause hemolytic anemias. However, some viruses can have a suppressive effect on the bone marrow.

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Publisher: Cambridge University Press
Print publication year: 2005

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  • Hypoplastic anemia
    • By Gary Kupfer, M.D. Division of Pediatric Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
  • Edited by Pedro A. de Alarcón, University of Tennessee, Eric J. Werner
  • Foreword by J. Lawrence Naiman, Stanford University School of Medicine, California
  • Book: Neonatal Hematology
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545306.007
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  • Hypoplastic anemia
    • By Gary Kupfer, M.D. Division of Pediatric Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
  • Edited by Pedro A. de Alarcón, University of Tennessee, Eric J. Werner
  • Foreword by J. Lawrence Naiman, Stanford University School of Medicine, California
  • Book: Neonatal Hematology
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545306.007
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Hypoplastic anemia
    • By Gary Kupfer, M.D. Division of Pediatric Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
  • Edited by Pedro A. de Alarcón, University of Tennessee, Eric J. Werner
  • Foreword by J. Lawrence Naiman, Stanford University School of Medicine, California
  • Book: Neonatal Hematology
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545306.007
Available formats
×