Generalized Bone Marrow Disorders

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Bone Marrow Aplasia

All causes of constitutional aplastic anemia may present with thrombocytopenia in the newborn (see Chapter 6).

Bone Marrow Infiltration

Benign disease (e.g., Gaucher disease, Niemann-Pick disease, osteopetrosis; Chapter 5) and malignant disease (e.g., congenital leukemia; Chapter 14) can present with neonatal thrombocytopenia.

Metabolic Causes

Hyperglycinemia with ketosis and the closely related metabolic disorder of methyl-malonic acidemia may cause periodic thrombocytopenia, as well as neutropenia, during infancy. Infants with these metabolic disorders present with lethargy, vomiting, and ketosis during the neonatal period. A similar disorder, isovaleric acidemia, is associated with a generalized marrow hypoplasia causing thrombocytopenia and neu-tropenia. Neonatal thrombocytopenic purpura has been reported in infants born to hyperthyroid mothers. The mechanism has not been defined.

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