newborn P1G1 baby with purpur and cephalhematoma Otherwise normal platelet of mother normal Your aproach Case presentation 1 WBC 18000 Hb 18grdl platelet 11000
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1. Case presentation 15 hours full term newborn P1G1 baby with purpur and cephalhematomaOtherwise normal platelet of mother :normalYour aproach?
2. Case presentation 1WBC 18000Hb 18gr/dl platelet 11000 PT 15 PTT 55What is your diagnosis?Management?
3. Case 1Apnea and seizure has happened before transfusion of platelet and IVIG Intubation and respiratory careControl of seizuresIVIG 1gr/kgRandom platelet on day 1 and 2Methyl prednisolon 1mg/8 houresImprovement after 3 daysPlatelet raising to 25000 ,50000, 110000 and discharged
4. Case 1
5. Neonatal alloimmune thrombocytopeniaWhat is your planning for subsequent pregnancy?
6. Case 235 days old baby with a purpuraNo fever no hx of uri or other illnessFeeding goodPhysical exam: petechia ,purpura Well nourished ,no hepatosplenomegaly, reflexes goodWhat blood tests should be done?
7. Case 2Hb :10.5 gr/dlWBC: 6700, poly 30% lymph 60%Platelet 16000 - 4000PT 13 PTT 44
8. case2
9. Case 2 Peripheral smear
10. Case 2 ITPManagement?IVIGPrednisonPlatelet?
11. Case 3A full term baby from mother with ITP by c/sApgar 9/10Pregnancy and delivery without complicationMother received prednisolone one week before delivery, platelet raised from 40000 to 70000How is your approach to this baby?
12. Case 3 Platelet count? Cord blood,24h,48hCNS ultrasonography?NICU care?Correlation between platelet count of mother and baby?
13. Case 3 cord Platelet count: 50000 day 1:55000Day 2: 38000What is your suggestion?Continue observation in the hospitalIVIG and prednisoloneDischarge and follow up
14. Case Study 4
15. Clinical presentation4 day old boy with refer to emergency unit due to cyanosis, feeding difficulty , abnormal movement, tachypnea, abnormal tone of crying and lethargy.
16. Ph/ETypical facial features include a bulbous-tipped nose, micrognathia, and malar flattening.Heart murmur and CHF with cardiogenic shockCleft palate
17. Emergency treatmentProstglandin infusionEchocardiographyTetralogy of Fallot With Pulmonary Atresia
18. procedureAfter Cardiac catheterization severe bleeding occurred.
19. Lab testCa:6.5Plt:35000/mm3PT:13/sPTT:33/sOther test:normal
20. PBS
21. Platelet function test:No response to RistocetinResponse to collagen ,ADP
22. Flow-cytometry:absence CD41a,CD 61
23. Bernard Soulier Syndromewith velocardiofacial syndrome