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A Newborn With Skin Lesions, Thrombocytopenia, and Gastrointestinal Bleeding

Razak, Abdul MD*,†,‡; Wahab, Muzafar G.A. MD*,†; Dowhaniuk, Jenna MD, FRCPC*,§; Breakey, Vicky R. MD, MEd, FRCPC*,∥; Ho, Man H.E. MD*,¶; Arredondo, Jorge MD, FRCPC*,¶; Shah, Jay K. MD, FRCPC*,†

Journal of Pediatric Hematology/Oncology: May 03, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPH.0000000000001500
Clinical and Laboratory Observations: PDF Only

A term infant girl was admitted for evaluation of severe thrombocytopenia. She also had purpura-like skin lesions. A complete blood count showed a platelet count of 40×109/L (normal value: 150 to 400×109/L). She received random donor platelet transfusions and intravenous immunoglobulin therapy; however, thrombocytopenia persisted. She developed bloody stools on day 5 of life and hematemesis on day 9. Upper gastrointestinal endoscopy revealed multiple small, 2 to 5 mm, vascular lesions throughout the stomach body and proximal duodenum. Our multidisciplinary team will discuss an approach towards a term infant with thrombocytopenia and gastrointestinal bleeding, the diagnostic challenges, and patient management.

*Department of Pediatrics

Division of Neonatology

§Division of Gastroenterology

Division of Hematology/Oncology

Division of Pathology, McMaster University, Hamilton, ON, Canada

Department of Pediatrics, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

The authors declare no conflict of interest.

Reprints: Jay K. Shah, MD, FRCPC, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1 (e-mail:

Received December 4, 2018

Accepted March 28, 2019

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