329 Neonatal Alloimmune Thrombocytopenia: Laboratory Findings and Clinical Management in 38 Cases

Abstract

Several clinical studies have documented the efficacy of probiotic bacteria, including Lactobacillus reuteri (L. reuteri) in the prevention and treatment of gastrointestinal disorders. In colicky infants an imbalance in the microflora with low counts of lactobacilli has been demonstrated which may be part of the etiopathogenesis of this disorder.Objective: The aim of this perspective randomised study was to investigate the efficacy and side effects profile of L. reuteri ATCC 55730 in the treatment of infantile colic. Methods: 49 breastfed colicky infants, diagnosed according to Wessel's criteria, aged 21 to 90 days, were randomly assigned to 2 treatments, one with the probiotic L. reuteri (P; 100.000.000 CFU/day) and the other with simethicone (S; Mylicon 6 mg/kg), once a day for 28 days. A questionnaire was given to the parents to monitor daily the crying time and side effects.Results: 46 infants completed the trial: 23 in the P group and 23 in the S group. The infants were similar regarding gestational age, birth weight, and gender (p Ͼ0.05). At baseline the daily average crying time in the P group was 210 min/day (SD 31) vs 208 min/day (SD 24) in the S group (p ϭ0.800). After 7 days, crying time was significantly reduced in the P group: 140 min/day (SD 51) vs 172 min/day (SD 43) (p ϭ0.025). By day 28, the crying time was significantly reduced in L. reuteri infants to only 20 min/day (SD 14) compared to simethicone, 156 min/day (SD 24) (pϽ0.005). No side effects were observed in either group.Conclusions: Our findings show that in breast-fed infant colic symptoms were significantly improved within one week of treatment with the probiotic Lactobacillus reuteri demonstrating the health advantages of L. reuteri to standard therapy in these infants. 329 DE-PARTMENT OF NEUROSCIENCE (ITALY)Neonatal alloimmune thrombocytopenia (NAITP) is a rare and transient disease caused by maternal IgG antibodies that react against the paternally inherited antigens expressed on fetal platelets (PLT). Screening and identification of antibodies in maternal blood sample is the main support in the diagnosis of NAITP. We report 38 cases of NAITP referred over the past 5 years. Immunohematologic study on mothers involved: 1) IgG antibody screening by a solid phase red cell adherence methodology; 2) identification of offending antibody carried out by ELISA; 3) HPA 1, 2, 3, 4, 5, 6 and HLA genotype of both parents and neonates through by PCR-SSP technology. The study protocol on infants included: 1) PLT count, 2) clinical examination, 3) detection of antibodies bound to PLT, 4) ultrasound screens. NAITP was clinically suspected in 50 infants, born by first pregnancy. Only 38 maternal sera were reactive with the following specificity: 8 anti HPA-1a, 2 anti HPA-1b, 2 anti HPA-1a ϩ HLA, 2 anti HPA-3a, 6 anti HPA-5b, 17 anti HLA, 1 auto HPA-5b. Specificity of HPA antibodies was confirmed by HPA genotype of parents. The infants with HPA-1a and HPA-1b immunization suffered from severe and symptomatic NAITP (bleeding and petechiae; PLT 7-12 x 10...