Neonatal cases

Question 1

What are the main causes of neonatal anaemia?

Answer 1

• Haemolysis: Immune, red cell membrane disorders, red cell enzymopathies
  - Blood loss
  - Red cell aplasia

Question 2

• Term baby, with high jaundice on day 2, no anaemia, not responding to double dose phototherapy for 12 hours
  - Bilirubin 380 micro micromol/l (High)
  - DCT +ve
  - What is the most likely diagnosis? //(what further investigations would you do?)

Answer 2

-Haemolytic disease of the newborn (HDN)
			//Further investigations: ABO/ Rh blood groups
			//-Can either be due to ABO or Rh blood groups

Question 3

• High jaundice and very mild anaemia at 12 hours age
  - Bilirubin raised
  - DCT negative
  - Indian mother has a blood disorder diagnosised in India
  - Maternal blood group: A Rh-
  - What is the most likely diagnosis?

Answer 3

-Hereditary Spherocytosis

Key point: anaemia is mild where in G6PD deficiency it is more moderate

Question 4

• Greek boy, 2 siblings had neonatal jaundice
• Term neonate with moderate anaemia and jaundice at 6 days
  - Raised Biliruben
• DCT negative
  - Maternal blood group: A RhD +ve
  - What is the most likely diagnosis?

Answer 4

-G6PD deficiency

Key points: Anaemia is moderate, compared with HS which has a mild anaemia

Question 5

-What red cell enzymopathies present with neonatal haemolysis?

Answer 5

• G6PD deficiency
  - Pyruvate kinase deficiency
  - Glutathione peroxidase deficiency

Question 6

• Preterm baby (28+weeks)
  - Hb 42g/l (vlow)
  - MCH abnormal
  - nRBC 280/100 wbc
  - Thrombocytopenia, high bilirubin
  - DCT negative
  - Maternal blood film: H- bodies (Golf ball appearance)
  - What is the most likely diagnosis?

Answer 6

-Alpha thalassaemia major