is observed in first week of life in approximately 60% full-term and 80% pre-term neonates. 1,2 The various modalities of treatment for neonatal jaundice include phototherapy, exchange transfusion, and drugs like phenobarbitone, intravenous immunoglobulin, metalloporphyrin, etc. Amongst them, phototherapy has emerged as the most widely used form for the treatment of unconjugated hyperbilirubinaemia. It reduces or blunts the rise of unconjugated bilirubin levels regardless of maturity, presence or absence of haemolysis. 3,4 Phototherapy though safe, is not free of side effects. Neonates receiving phototherapy have increased insensible water loss, redistribution of blood flow, watery diarrhoea, irritability, rise in temperature, retinal damage, bronze baby syndrome, gonadal toxicity, impaired maternal-infant interaction, hypocalcaemia, riboflavin deficiency, DNA strand breakage, chromosomal mutations damage, and in few studies even thrombocytopenia. 1,2,5,7 Thrombocytopenia as a side effect of phototherapy that has not been described in the standard textbooks although many authors did try to look into this particular side effect. Maurer et al 5,6 and Pishwa et al 7 observed in their studies that neonates exposed to phototherapy had decreased platelet counts and increased platelet turnover.This study was done with an aim to find the incidence of thrombocytopenia in neonates with indirect hyperbilirubinaemia receiving phototherapy.
MATERIALS AND METHODThis was a prospective study done at a tertiary care hospital between July 2007 and July 2009; in consecutively enrolled cohort of apparently healthy neonates, who developed indirect hyperbilirubinaemia and required phototherapy irrespective of gestational age and birth weight. The indication of phototherapy was based on the guidelines of American Academy of Pediatrics 2004. 8 The neonates having a base line platelet count of more than 150,000/mm 3 before starting phototherapy were included in the study. Neonates having features suggestive of haemolysis, direct hyperbilirubinaemia, sepsis, anti-platelet drugs given to baby or mother, haemangioma, and other congenital anomalies were excluded. Neonates who developed features suggestive of sepsis during phototherapy were also excluded.Neonates who fulfilled the inclusion criteria were admitted to the hospital. After a detailed history, clinical examination and baseline investigations all babies were put on continuous phototherapy. Platelet counts were performed at admission, 24 hours,
Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonatesMaj Sanjeev Khera*, Col Rakesh Gupta † ABSTRACT BACKGROUND