Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down's syndrome

Abstract

Background: The pathogenesis of thrombocytopenia during the neonatal period in Down's syndrome (DS) infants remains unclear.Objective: To elucidate kinetic changes of serum thrombopoietin (TPO) level and platelet count, and their correlation in DS neonates.Study Design: Twelve DS infants (male/female: 7/5, term/late preterm: 10/2) born between 1997 and 2007 were included. Blood samples were serially collected during the neonatal period and serum TPO levels were determined in 44 sera using an enzyme-linked immunosorbent assay.Results: Thrombocytopenia <150 Â 10 9 per liter was observed in seven (58%) patients. In 12 DS patients, the median TPO value showed 2.86 fmol ml -1 on day 0, rose to 4.64 fmol ml -1 on day 2, and thereafter decreased to 4.30 fmol ml -1 on day 5, 2.40 fmol ml -1 on days 11-15, and 1.75 fmol ml -1 on days 28-30. This kinetics parallels that in historical non-DS controls. In 35 pair sample analysis from 11 patients without transient myeloproliferative disease, TPO level inversely correlated with platelet count (r ¼ À0.38, P ¼ 0.023). However, there was no significant difference in TPO concentrations between thrombocytopenic and non-thrombocytopenic DS individuals.Conclusions: This is the first study to describe the relationship between TPO level and platelet count in neonates with DS. Median TPO levels and their kinetic changes in DS neonates are comparable to those in non-DS controls. In contrast to earlier findings in several studies showing higher TPO concentrations in thrombocytopenic non-DS newborns than those in non-thrombocytopenic counterparts, the response of the TPO system to thrombocytopenia in DS during the neonatal period seems suboptimal.

Circulating Blasts and Associated Hematologic Disorders in Neonates with Down Syndrome

“…1,16 Hord et al 23 noted that the most likely explanation for thrombocytopenia in infants with trisomy 21 is the presence of megakaryocytic dysregulation, a phenomenon previously described in the development of transient myeloproliferative disorder and acute nonlymphoblastic leukemia in these infants [24][25][26][27] ; this dysregulation may involve thrombopoietin levels. 28 Of note, using a definition of < 100,000/mm 3 , our overall incidence of thrombocytopenia was similar to that observed by Hord et al 23 in a smaller study (35% versus 28%, respectively; p ¼ 0.51). Dixon et al 20 reported that thrombocytopenia was more likely in neonates who had polycythemia.…”

Down Sendromlu hastalarda subklinik hipotiroidizm ve hematolojik parametreler arasındaki ilişki

“…In a study of patients with thyroid dysfunction, Yu HM et al showed that SCH and RDW were associated significantly when patients with SCH and the control group were compared [17]. RDW and serum TSH levels were reported to be associated significantly in another study [18]. In our study, we found that RDW was significantly higher in patients with DS compared to the control group.…”

Proteomic profiles for Alzheimer's disease and mild cognitive impairment among adults with Down syndrome spanning serum and plasma: An Alzheimer's Biomarker Consortium–Down Syndrome (ABC–DS) study

“…When TPO was included in the model, it was found to play a significant role in both the MCI‐DS and DS‐AD proteomic profiles spanning fractions. TPO is a known glycoprotein hormone that aids in the production of platelets 24,25 and in DS, TPO has been almost exclusively studied among pediatric cases due to high level of thrombocytopenia 26‐28 . Although TPO exhibited an unexpectedly high CV for plasma (and was initially excluded from derived protoemic profiles), the inclusion of TPO did not significantly change the detection accuracy of the proteomic profiles despite its prominence within the models.…”