Infantile Pyknocytosis

Rare miscellaneous causes Hexokinase deficiency Galactosemia

Blood loss Iatrogenic (sampling) Fetomaternal/fetoplacental Cord problems Twin to twin Internal hemorrhage

Infection, e.g., HIV

Toxoplasmosis CMV Rubella Syphilis

Hereditary spherocytosis Hereditary elliptocytosis Hereditary stomatocytosis Infantile pyknocytosis Pyruvate kinase deficiency G6PD deficiency Disseminated intravascular coagulation Vitamin E deficiency

Fig. 2-4. Approach to the diagnosis of anemia in the newborn.

Table 2-6. Clinical and Laboratory Evaluation of Anemia in the Newborn


Obstetrical history Family history

Physical examination

Laboratory tests

Complete blood count Reticulocyte count Blood smear

Coombs' test (direct and indirect) Blood type of baby and mother Bilirubin level

Kleihauen-Betke test on mother's blood (fetal red cells in maternal blood)

Studies for neonatal infection

Ultrasound of abdomen and head

Red cell enzyme assays (if clinically indicated)

Bone marrow (if clinically indicated)

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