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Thrombocytopenia following exchange transfusion in neonates

Journal of Perinatology volume 40, page 1120 (2020)Cite this article

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We read with interest the cohort study by Wolf et al. [1] in which the authors addressed safety issues related to exchange transfusion (ET) in neonatal hyperbilirubinemia. We request the authors for clarification on a few issues. In this study, the incidence of thrombocytopenia was 18% before ET, 46% on the next day of ET, and 64% at 7 days after ET. The first value above is consistent with the published reports [2, 3]. However, the maximum thrombocytopenia (64%) at 7 days after ET is not similar to other studies [2, 4], which warrants an explanation. Similarly, the nadir of the calcium level is seen in the immediate post ET period and recovers thereafter [2]. However, in this study, hypocalcemia was maximum on day 7 post ET, which also needs an explanation. Furthermore, even after 7 days of ET, the median bilirubin level remained high in late-preterm and term infants—are there physiological explanations for this finding? We were also not sure whether it is a routine practice to keep term infants in the hospital for up to 7 days after ET. If this was due to infant illnesses, those details were not provided. Clarifications for the above issues would be helpful.

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References

  1. Wolf MF, Childers J, Gray KD, Chivily C, Glenn M, Jones L, et al. Exchange transfusion safety and outcomes in neonatal hyperbilirubinemia. J Perinatol. 2020. http://www.nature.com/articles/s41372-020-0642-0. Accessed 9 Mar 2020.

  2. Chacham S, Kumar J, Dutta S, Kumar P. Adverse events following blood exchange transfusion for neonatal hyperbilirubinemia: a prospective study. J Clin Neonatol. 2019;8:79.

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Authors and Affiliations

  1. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Jogender Kumar & Jitendra Meena

  2. Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India

    Arushi Yadav

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  1. Jogender Kumar
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  2. Arushi Yadav
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  3. Jitendra Meena
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Correspondence to Jogender Kumar.

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Kumar, J., Yadav, A. & Meena, J. Thrombocytopenia following exchange transfusion in neonates. J Perinatol 40, 1120 (2020). https://doi.org/10.1038/s41372-020-0683-4

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