Thrombopoietin (Tpo) in the fetus and neonate: Tpo concentrations in preterm and term neonates, and organ distribution of Tpo and its receptor (c-mpl) during human fetal development

Sola, Martha C.; Juul, Sandra E.; Meng, Yuesheng; Garg, Shaily; Sims, Paul W.; Calhoun, Darlene A; Dame, John B.; Christensen, Robert D.

doi:10.1016/s0378-3782(98)00077-2

Cited by 53 publications

(36 citation statements)

References 39 publications

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“…It seems to contradict the hypothesis that the anti-HPA-1a antibodies would bind to glycoprotein IIb/IIIa on megakaryocytes and either inhibit thrombocytopoiesis or destroy them outright (15)(16)(17). We, like others (21,22), found slightly but significantly higher Tpo levels in fetal/neonatal plasma compared with plasma from adults (Fig. 1).…”

Section: Discussionsupporting

confidence: 83%

Fetal and Neonatal Thrombopoietin Levels in Alloimmune Thrombocytopenia

et al. 2002

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Section: Discussionsupporting

confidence: 83%

Fetal and Neonatal Thrombopoietin Levels in Alloimmune Thrombocytopenia

et al. 2002

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“…29 It is well established that Tpo concentrations in non-thrombocytopenic preterm and term infants are significantly higher than in healthy adults. [30][31][32] Both preterm and term infants show similar Tpo concentrations during the first weeks of life; concentrations increase after birth with a peak on the 2nd day and then gradually decrease to levels seen in the cord blood by the end of the first month of life. 27,32 Previous reports demonstrated that the platelet counts of neonatal rhesus monkeys began to increase 4 to 6 days after the administration of pegylated recombinant human megakaryocyte growth and development factor with counts peaking after approximately 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

Platelet reference ranges for neonates, defined using data from over 47 000 patients in a multihospital healthcare system

et al. 2008

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Objective: Identifying a platelet count as abnormal (thrombocytopenia or thrombocytosis) can facilitate recognizing various disease states. However, the published reference ranges for platelet counts in neonates may be imprecise, as they were generated from relatively small sample sizes and compiled before modern platelet enumeration methods. Study design:We derived new neonatal reference ranges for platelet counts and mean platelet volume (MPV) measurements using electronic data accumulated during a recent 6-year period from a multihospital healthcare system.Result: Platelet counts were obtained between the first and the 90th day after birth, from 47 291 neonates delivered at 22 to 42 weeks gestation. The first platelet counts obtained in the first 3 days of life, increased over the range of 22 to 42 weeks gestation. In those born p32 weeks gestation, the lower reference range (5th percentile) was 104 200 ml À1 , but it was 123 100 ml À1 in late-preterm and -term neonates. Advancing postnatal age had a significant effect on platelet counts; during the first 9 weeks, the counts fit a sinusoidal pattern with two peaks; one at 2 to 3 weeks and a second at 6 to 7 weeks. The upper limit of expected counts (95th percentile) during these peaks were as high as 750 000 ml À1 . Conclusion:The figures herein describe reference ranges for platelet counts and MPV determinations of neonates at various gestational ages during their first 90 days. Expected values differ substantially from the 150 000 ml À1 to 450 000 ml À1 range previously used to define neonatal thrombocytopenia and thrombocytosis. The new definitions will render the diagnoses of neonatal thrombocytopenia and thrombocytosis less commonly than when the old definitions were used, because the new ranges are wider than 150 000 ml À1 to 450 000 ml À1 .

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“…4 Recently, several studies have clarified the relationship between blood TPO level and platelet count in thrombocytopenic and non-thrombocytopenic non-DS neonates. [5][6][7][8][9][10][11][12] Accumulating evidence has shown that although neonates of all gestational ages produce endogenous TPO, their TPO response to thrombocytopenia may be suboptimal. 5,6 In contrast with extensive studies about thrombocytopenia in non-DS neonates, [5][6][7][8][9][10][11][12] little is known about underlying mechanisms including TPO contribution responsible for thrombocytopenia in DS newborns.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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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.

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Thrombopoietin (Tpo) in the fetus and neonate: Tpo concentrations in preterm and term neonates, and organ distribution of Tpo and its receptor (c-mpl) during human fetal development

Cited by 53 publications

References 39 publications

Fetal and Neonatal Thrombopoietin Levels in Alloimmune Thrombocytopenia

Fetal and Neonatal Thrombopoietin Levels in Alloimmune Thrombocytopenia

Platelet reference ranges for neonates, defined using data from over 47 000 patients in a multihospital healthcare system

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

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