A 768 g female neonate, born at 25 weeks’ gestation, developed sepsis due to methicillin-resistant Staphylococcus epidermidis on day 14. Severe thrombocytopenia was observed, and hemophagocytic macrophages were identified in her peripheral blood smear. Cytokine profiles at the time of onset suggested that an inflammatory cytokine storm had activated lymphocytes and macrophages, leading to platelet phagocytosis. After administration of vancomycin for 14 days and immunoglobulin therapy, she improved without any complications. Considering the results of cytokine profiles, early intervention for infection may have prevented progression to hemophagocytic lymphohistiocytosis and reduced the severity of clinical symptoms.
Abstract/References
Peripheral platelet phagocytosis in an extremely low birth weight infant:a case report
Daisuke Hatanaka, Kana Ito, Eisuke Fukama, Tomoaki Nomura, Michiko Kusakari, Hidehiro Takahashi, Toshihiko Nakamura, Naoto Takahashi
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Daisuke Hatanaka
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Kana Ito
Department of Neonatology, Japanese Red Cross Musashino Hospital
Department of Pediatrics, National Defense Medical College Hospital
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Eisuke Fukama
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Tomoaki Nomura
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Michiko Kusakari
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Hidehiro Takahashi
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Toshihiko Nakamura
Department of Neonatology, Japanese Red Cross Musashino Hospital
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Naoto Takahashi
Department of Pediatrics, Tokyo University School of Medicine
Abstract
References
1. Takahashi N, Uehara R, Kobayashi M, et al. Cytokine profiles of seventeen cytokines, growth factors and chemokines in cord blood and its relation to perinatal clinical findings. Cytokine, 49:331-337, 2010.
3. Brown RE, Rimsza LM, Pastos K, et al. Effects of sepsis on neonatal thrombopoiesis. Pediatr Res, 64(4):399-404, 2008.
4. Levit O, Bhandari V, Li FY, Shabanova V, Gallagher PG, Bizzarro MJ. Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis. Pediatr Infect Dis J, 33(2):143-146, 2014.
10. Nakamura T, Hatanaka D, Kashima K, et al. Serial changes of cytokine profiles and acute phase reactants in a male infant with neonatal leukemoid reaction and his mother. (in Japanese) J Jpn Soc Perin Neon Med, 54(4):1098-1104, 2018.
12. Saito M, Takahashi N, Ueda S, et al. Cytokine profile in a premature infant with systemic Bacillus cereus infection. Pediatr Int, 52:e34-36, 2010.