Polycythemia neonatorum represents a clinical condition due to a high hematocrit (above 65% or 2 standard deviations above the normal value for age, measured in a venous, not capillary blood sample) and characterized by signs of hyperviscosity, poor tissue oxygenation and perfusion and a tendency for thrombosis. The test should be performed using venous blood because capillary blood normally has a higher hematocrit value.
Presentation
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters [1], motor delay and respiratory distress, tachypnea, apnea, and cyanosis. However, some remain asymptomatic [2]. Neurologic suffering is caused by low cerebral blood flow and impaired tissue metabolism due to hypoglycemia and hypocalcemia [3] [4]. Respiratory abnormalities are due to reduced pulmonary blood flow and increased pulmonary resistance, which can lead to hypoxia [5]. Poor feeding may be a consequence of the increased respiratory effort, recurrent vomiting or heart failure. Abdominal distension can sometimes be observed. Debate exists on whether necrotizing enterocolitis, seen in some newborn polycythemia cases, is caused by the blood abnormality itself or by its treatment.
Clinical examination may also reveal plethora, signs of heart failure, transient arterial hypertension and genitourinary abnormalities: oliguria, hematuria, and priapism. Peripheral gangrene and testicular infarctions are seldom noticed.
Neonatal polycythemia often occurs in children with ABO or Rh incompatibility. In this case, jaundice is observed and whether it is due to the polycythemia (and breakdown of a high number of red blood cells) or the blood type incompatibility is hard to determine.
Entire Body System
- Asymptomatic
A 23 (74.1%) of polycythemic newborns were asymptomatic followed by respiratory distress 4 (12.9%). Cyanosis comes later with 2 (6.45%) and poor feeding 1 (3.22%). [itmedicalteam.pl]
If there was no documentation of symptoms, then it was deemed a screen on an asymptomatic infant. [journals.lww.com]
However, some remain asymptomatic. Neurologic suffering is caused by low cerebral blood flow and impaired tissue metabolism due to hypoglycemia and hypocalcemia. [symptoma.com]
Most polycythaemic infants are asymptomatic. Increased viscosity of blood may be associated with symptoms of hypoperfusion. Clinical features related to polycythemia may affect all organ systems. [semanticscholar.org]
Restrictive treatment for neonatal asymptomatic polycythemia is not associated with an increased risk of short-term complications. KEYWORDS Polycythemia - neonate - treatment REFERENCES 1 Gross G P, Hathaway W E, McGaughey H R. [thieme-connect.com]
- Plethora
See Chapter Specific Guidelines Applies to • Plethora of newborn • Polycythemia due to: • donor twin transfusion • maternal-fetal transfusion - ICD-9-CM Chapters, Sections & Parents 760-779 Certain Conditions Originating In The Perinatal Period Includes [coding-pro.com]
These cases termed ‘symptomatic neonatal plethora’ were caused by large placental transfusions associated with delayed clamping of the umbilical cord. [karger.com]
Convert to ICD-10-CM : 776.4 converts directly to: 2015/16 ICD-10-CM P61.1 Polycythemia neonatorum Applies To Plethora of newborn Polycythemia due to: donor twin transfusion maternal-fetal transfusion ICD-9-CM Volume 2 Index entries containing back-references [icd9data.com]
Clinical examination may also reveal plethora, signs of heart failure, transient arterial hypertension and genitourinary abnormalities: oliguria, hematuria, and priapism. Peripheral gangrene and testicular infarctions are seldom noticed. [symptoma.com]
- Falling
D75.1 Secondary polycythemia 2016 2017 2018 2019 Billable/Specific Code Applicable To Acquired polycythemia Emotional polycythemia Erythrocytosis NOS Hypoxemic polycythemia Nephrogenous polycythemia Polycythemia due to erythropoietin Polycythemia due to fall [icd10data.com]
"D75.0", "D75.8", "D75.9" ], "extended": { "inclusionTerm": [ "Acquired polycythemia", "Emotional polycythemia", "Erythrocytosis NOS", "Hypoxemic polycythemia", "Nephrogenous polycythemia", "Polycythemia due to erythropoietin", "Polycythemia due to fall [phcoder.perceptionhealth.com]
[…] excludes: hereditary ovalocytosis (D58.1)| D75.1 Secondary polycythemia Inclusion: Acquired polycythemia| Emotional polycythemia| Erythrocytosis NOS| Hypoxemic polycythemia| Nephrogenous polycythemia| Polycythemia due to erythropoietin| Polycythemia due to fall [codelay.com]
[…] ovalocytosis (D58.1) Familial erythrocytosis D751 Secondary polycythemia INCLUSION TERMS: Acquired polycythemia Emotional polycythemia Erythrocytosis NOS Hypoxemic polycythemia Nephrogenous polycythemia Polycythemia due to erythropoietin Polycythemia due to fall [gotnpi.com]
- Trisomy 21
Polycythemia is more common in newborns of IUGR, perinatal asphyxia, trisomy 21,twin pregnancy, delayed cord clamping and congenital adrenal hyperplasia. [worldwidejournals.com]
These defects are not usually apparent at the doctor's examination... read more ), Down syndrome Down Syndrome (Trisomy 21) Down syndrome is a chromosome disorder caused by an extra chromosome 21 that results in intellectual disability and physical abnormalities [msdmanuals.com]
Genetics disorders Genetic conditions that increase fetal erythropoiesis include the following: Trisomy 13 Trisomy 18 Trisomy 21 Beckwith-Wiedemann syndrome Hypertransfusion Polycythemia-hyperviscosity could also be secondary to increased blood volume [emedicine.medscape.com]
Chromosomal abnormalities (including Turner’s syndrome, trisomy 18, trisomy 21): Certain chromosomal abnormalities are associated with a paucity of intrahepatic bile ducts, resulting in cholestasis. [pathophys.org]
- Poor Feeding
Cyanosis comes later with 2 (6.45%) and poor feeding 1 (3.22%). [itmedicalteam.pl]
Poor feeding may be a consequence of the increased respiratory effort, recurrent vomiting or heart failure. Abdominal distension can sometimes be observed. [symptoma.com]
Although infants can become sufficiently anemic to develop congestive heart failure, more often they manifest evidence of poor feeding or lack of activity. [uihc.org]
Impaired gut bloodflow predisposes to poor tolerance of feeds necessitating a delay in starting milk. [intranet.tdmu.edu.ua]
Respiratoric
- Respiratory Distress
Prematurity, small–for gestational age, low SpO2, respiratory distress and hyperbilirubinemia have higher incidence than other studies. [worldwidejournals.com]
Frequent signs and symptoms included "feeding problems" (21.8%), plethora (20.0%), lethargy (14.5%), cyanosis (14.5%), respiratory distress (9.1%), jitteriness (7.3%), and hypotonia (7.3%). [pediatrics.aappublications.org]
There was partial agreement with study by Singh, who showed lethargy, respiratory distress and jitteriness (11.1%, 14.8%, 25.9%) respectively [26]. [itmedicalteam.pl]
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea [symptoma.com]
The neonatal pathology associated with neonatal hypoglycemia is, in order of frequency: prenatal hypoxia, hypothermia, respiratory distress, sepsis, neonatal shock, and policitemia. [tmj.ro]
- Tachypnea
The leading causes of admission in polycythemic patients were Respiratory distress syndrome 37.5%(n=12), transient tachypnea of newborn 24.87%(n=7) and hyperbilirubinemia 15.62%(n=5). [worldwidejournals.com]
Neonatal plethora must be considered as one cause of Ê»transient tachypnea of the newborn’. © 1977 S. Karger AG, Basel Article / Publication Details First-Page Preview [karger.com]
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea [symptoma.com]
Other and unspecified atelectasis Atelectasis: NOS originating in the perinatal period partial originating in the perinatal period secondary originating in the perinatal period Pulmonary collapse originating in the perinatal period 770.6 Transitory tachypnea [theodora.com]
- Respiratory Abnormalities
Respiratory abnormalities are due to reduced pulmonary blood flow and increased pulmonary resistance, which can lead to hypoxia. Poor feeding may be a consequence of the increased respiratory effort, recurrent vomiting or heart failure. [symptoma.com]
Gastrointestinal
- Failure to Thrive
Brief resolved unexplained event -- BRUE (Medical Encyclopedia) Crying - excessive (0-6 months) (Medical Encyclopedia) Failure to thrive (Medical Encyclopedia) Hemorrhagic disease of the newborn (Medical Encyclopedia) Hyperglycemia - infants (Medical [icdlist.com]
[…] to thrive, urosepsis, poor urinary stream, and straining or grunting while voiding Appearance of erythema toxicum Multiple erythematous macules and papules (1 to 3 mm in diameter) that rapidly progress to pustules on an erythematous base Marijuana use [brainscape.com]
[…] to gain weight, failure to thrive) 缺乏預期正常生理發育,生長遲緩 Ill-defined conditions 其他診斷欠明之病態 Accidental fall 意外墜落 Vaccine against viral hepatitis B b型肝炎 預防注射 Routine infant or child health check 嬰幼兒例行之健康檢查 Observation for suspected condition, newborn 新生兒可疑病態之觀察 [money511.com]
[…] to thrive Multifactorial causes Tachycardia, fever Infection causing cholestasis Diagnosis Am Fam Physician. 2002 Feb 15; 65 ( 4 ):599-606. [pathophys.org]
("failure to thrive"), etc. [uihc.org]
- Abdominal Distension
Abdominal distension can sometimes be observed. Debate exists on whether necrotizing enterocolitis, seen in some newborn polycythemia cases, is caused by the blood abnormality itself or by its treatment. [symptoma.com]
distension due to enlarged overdistended bladder or urinary ascites, difficulty with voiding, or a poor urinary stream, failure to thrive, urosepsis, poor urinary stream, and straining or grunting while voiding Appearance of erythema toxicum Multiple [brainscape.com]
(i.e abdominal distension/discolouration, abnormal NG aspirate, abnormal stools.) Ensure clear documentation of procedure. Complications Hypothermia-ensure fluids are warmed Respiratory distress. [lhp.leedsth.nhs.uk]
Intra-abdominal bleeding should be considered for every infant presenting with shock, pallor, unexplained anemia, and abdominal distension. Overlying abdominal skin may have bluish discoloration. [intranet.tdmu.edu.ua]
- Recurrent Vomiting
Poor feeding may be a consequence of the increased respiratory effort, recurrent vomiting or heart failure. Abdominal distension can sometimes be observed. [symptoma.com]
Cardiovascular
- Thrombosis
Urine analysis may reveal hematuria and proteinuria if renal vein thrombosis has occurred. A low glomerular filtration rate has also been described. [symptoma.com]
Thrombosis is the presenting symptom in 20% of patients with PV. It is a rare disease with an incidence of 2.3/100.000 people per year, and is even more uncommon in children and adolescents. [scielo.mec.pt]
Unit, National Hemophilia Center and Institute of Thrombosis and Hemostasis, Chaim Sheba Medical Center, Tel Hashomer, Israel Further Information Publication History Publication Date: 10 June 2011 (online) ABSTRACT Partial exchange transfusion (PET) [thieme-connect.com]
Manifestations include plethora, vertigo, headache, and thrombosis. erythremia [medical-dictionary.thefreedictionary.com]
In contrast, the risk of thrombosis exceeds 20 %. [aetna.com]
- Cyanosis
Cyanosis comes later with 2 (6.45%) and poor feeding 1 (3.22%). [itmedicalteam.pl]
[…] pol·y·cy·the·mi·a ve·ra [MIM*263300] a chronic form of polycythemia of unknown cause; characterized by bone marrow hyperplasia, an increase in blood volume as well as in the number of red blood cells, redness or cyanosis of the skin, and splenomegaly. [medical-dictionary.thefreedictionary.com]
[…] with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea, and cyanosis [symptoma.com]
Frequent signs and symptoms included "feeding problems" (21.8%), plethora (20.0%), lethargy (14.5%), cyanosis (14.5%), respiratory distress (9.1%), jitteriness (7.3%), and hypotonia (7.3%). [pediatrics.aappublications.org]
Tachypnea, mild cyanosis, plethoric skin color, and neurological depression persisted on average for 30 h after birth. Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. [karger.com]
- Tachycardia
[…] syndrome I2789Other specified pulmonary heart diseases I279Pulmonary heart disease, unspecified P2938Other persistent fetal circulation PDX Collection 1029 P2981Cardiac arrest of newborn PDX Collection 1030 P290Neonatal cardiac failure P2911Neonatal tachycardia [cms.gov]
Many patients may require the same volume of normal saline to be given over an hour a 2nd time for tachycardia while their blood volume equilibrates. The push-pull method has been associated with an increased risk of NEC. [uihc.org]
Other manifestations like hypotonia, sleepiness, irritability, jitteriness, tachycardia and cyanosis may be seen in some babies [10,11]. [itmedicalteam.pl]
[…] disease Cholestasis (Impaired excretion) Jaundice Accumulation of conjugated bilirubin Hepatomegaly Obstruction of hepatic outflow ducts Pale stool Lack of stercobilin (which normally gives feces its dark colour) Failure to thrive Multifactorial causes Tachycardia [pathophys.org]
- Heart Failure
Poor feeding may be a consequence of the increased respiratory effort, recurrent vomiting or heart failure. Abdominal distension can sometimes be observed. [symptoma.com]
Although infants can become sufficiently anemic to develop congestive heart failure, more often they manifest evidence of poor feeding or lack of activity. [uihc.org]
Heart and Lungs: Heart failure due to hypoxic ischaemic damage. Dilated cardiomyopathy, with increased tricuspid incompetence and poor contractility. Beware of fluid overload during resuscitation. [intranet.tdmu.edu.ua]
Is acute heart failure the cause of the neonatal syndrome in children born of diabetic mothers? Ann. pédiat. (1957) There are more references available in the full text version of this article. [sciencedirect.com]
- Cardiomegaly
Postero-anterior thoracic radiography shows pulmonary congestion and cardiomegaly, therefore echocardiography is indicated in affected babies. This test will highlight the presence of decreased cardiac output and increased pulmonary resistance. [symptoma.com]
[…] and problems that may arise if Polycythemia neonatorum is left untreated: respiratory problems feeding problems lethargy convulsions hypotonia jitteriness hypoglycemia hyperbilirubinemia hypocalcemia persistent pulmonary hypertension of the newborn cardiomegaly [tabletwise.net]
Chest X-rays showed mild cardiomegaly, pulmonary congestion and edema, and pleural effusions. Although the course was in general benign, phlebotomy was considered to be indicated in three infants to treat progressive clinical deterioration. [karger.com]
Associated laboratory findings: Abnormal chest X-ray: cardiomegaly, increased vascularity, hyperaeration, alveolar infiltrates, pleural effusions. [uihc.org]
Liver, Gall & Pancreas
- Jaundice
Yea... 762 x 529 jpeg 133kB pic source Neonatal Jaundice 1 638 x 479 jpeg 75kB pic source Jaundice charts - Neon... 1242 x 864 jpeg 252kB pic source Neonatal Jaundice 1 638 x 479 jpeg 87kB pic source Candidiasis symptoms m... 236 x 177 jpeg 10kB pic [mnogolok.info]
[…] from other and unspecified hepatocellular damage P59.20 Neonatal jaundice from unspecified hepatocellular damage P59.29 Neonatal jaundice from other hepatocellular damage P59.3 Neonatal jaundice from breast milk inhibitor P59.8 Neonatal jaundice from [icd10data.com]
[…] for signs of worsening Pathological jaundice · Clinical jaundice detected < 24 hrs of age · Rise in TSB by > 5 mg/ dl/ day ( >86 umol/l/day) · TSB > 15 mg/ dl ( > 257 umol/l) · Clinical jaundice persisting > 14 Ds · Clay/white colored stool and/or dark [pt.slideshare.net]
Breast milk jaundice : Distinct from breastfeeding jaundice, breast milk jaundice develops in the second week of life, lasts longer than physiologic jaundice, and has no other identifiable cause. [pathophys.org]
- Neonatal Jaundice
Yea... 762 x 529 jpeg 133kB pic source Neonatal Jaundice 1 638 x 479 jpeg 75kB pic source Jaundice charts - Neon... 1242 x 864 jpeg 252kB pic source Neonatal Jaundice 1 638 x 479 jpeg 87kB pic source Candidiasis symptoms m... 236 x 177 jpeg 10kB pic [mnogolok.info]
jaundice from other and unspecified hepatocellular damage P59.20 Neonatal jaundice from unspecified hepatocellular damage P59.29 Neonatal jaundice from other hepatocellular damage P59.3 Neonatal jaundice from breast milk inhibitor P59.8 Neonatal jaundice [icd10data.com]
[…] neonatorum (L00)| staphylococcal scalded skin syndrome (L00)| P58.3 Neonatal jaundice due to polycythemia P61.1 Polycythemia neonatorum P83.0 Sclerema neonatorum P83.8 Other specified conditions of integument specific to newborn Inclusion: Bronze baby [codelay.com]
jaundice due to other excessive hemolysis 其他過量溶血所致之新生兒黃疸 P580 Neonatal jaundice due to bruising 瘀傷所致之新生兒黃疸 P581 Neonatal jaundice due to bleeding 出血所致之新生兒黃疸 P582 Neonatal jaundice due to infection 感染所致之新生兒黃疸 P583 Neonatal jaundice due to polycythemia [csh.org.tw]
- Scleral Icterus
The most notable signs of hyperbilirubinemia are jaundice and scleral icterus. Jaundice refers to yellowing of the skin, which can be seen by blanching the skin with digital pressure. [pathophys.org]
Urogenital
- Oliguria
Clinical examination may also reveal plethora, signs of heart failure, transient arterial hypertension and genitourinary abnormalities: oliguria, hematuria, and priapism. Peripheral gangrene and testicular infarctions are seldom noticed. [symptoma.com]
Renal problems encountered in polycythaemia are decrease in glomerular filtration rate, oliguria, haematuria, proteinuria and renal vein thrombosis (16,39). [lhp.leedsth.nhs.uk]
The cry is feeble and the infant is lethargic with depressed reflexes, bradycardia and oliguria. The skin feels cold to the touch and is usually below 32°C ( May drop as low as 27°C ). [intranet.tdmu.edu.ua]
- Hematuria
Urine analysis may reveal hematuria and proteinuria if renal vein thrombosis has occurred. A low glomerular filtration rate has also been described. [symptoma.com]
Neurologic
- Seizure
None has a persisting seizure disorder at present, although late recurrence of seizures after an eight year seizure free interval has been documented by Sran and Baumann.10 This seven year review of newborn infants admitted with seizures to a neonatal [fn.bmj.com]
Symptoms Symptoms may include: Extreme sleepiness Feeding problems Seizures Exams and Tests There may be signs of breathing problems, kidney failure, low blood sugar, or newborn jaundice. [healthing.ca]
The patient's mother explains that she observed what she believed to be seizure-like activity just before you arrived in the room. The mother has a history of type two diabetes mellitus and during childbirth there was a delay in cord clamping. [step2.medbullets.com]
Differential Diagnosis section highlights 50 new topics, including: alcohol-related seizures, dysentery and inflammatory enterocolitis, hair loss, cystic and solid pancreatic lesions, and COPD decompensation. [books.google.com]
- Irritability
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea [symptoma.com]
The infant is irritable and may have tremors when disturbed. [studystack.com]
The Apgar score is typically used to gauge the clinical status of newborn infants at one and five minutes after birth using the following parameters: heart rate, respiratory effort, muscle tone, reflex irritability to tactile stimulation, and skin color [amboss.com]
Table 2 Signs & Symptoms Complications Apnoea Altered consciousness Cyanosis Hypoglycaemia Feeding problem Hypocalcaemia Vomiting Heperbilirubinaemia Irritability Necrotising enterocolitis Jitteriness Oliguria Tremor Haematuria Lethargy Renal vein thrombosis [lhp.leedsth.nhs.uk]
In a quiet infant, the examination should proceed from the least invasive and noxious elements of the exam (auscultation of heart and lungs) to those most likely to irritate the infant (examination of the hips and eliciting the Moro reflex). [elearning.sumdu.edu.ua]
- Lethargy
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea [symptoma.com]
Below is the list of complications and problems that may arise if Polycythemia neonatorum is left untreated: respiratory problems feeding problems lethargy convulsions hypotonia jitteriness hypoglycemia hyperbilirubinemia hypocalcemia persistent pulmonary [tabletwise.net]
Frequent signs and symptoms included "feeding problems" (21.8%), plethora (20.0%), lethargy (14.5%), cyanosis (14.5%), respiratory distress (9.1%), jitteriness (7.3%), and hypotonia (7.3%). [pediatrics.aappublications.org]
There was partial agreement with study by Singh, who showed lethargy, respiratory distress and jitteriness (11.1%, 14.8%, 25.9%) respectively [26]. [itmedicalteam.pl]
Table 2 Signs & Symptoms Complications Apnoea Altered consciousness Cyanosis Hypoglycaemia Feeding problem Hypocalcaemia Vomiting Heperbilirubinaemia Irritability Necrotising enterocolitis Jitteriness Oliguria Tremor Haematuria Lethargy Renal vein thrombosis [lhp.leedsth.nhs.uk]
- Tremor
(M3.PD.17.21) During the exam of a 2-day-old female neonate you determine that she appears lethargic, cyanotic, and has a coarse tremor of her right arm. [step2.medbullets.com]
The infant is irritable and may have tremors when disturbed. [studystack.com]
Newborns with polycythemia neonatorum have nonspecific findings, related most often to the central nervous and respiratory systems: irritability or lethargy, hypotonia, seizures, tremor or jitters, motor delay and respiratory distress, tachypnea, apnea [symptoma.com]
Gastroenteritis/Colitis) Esophagogastric Ring (Lower Esophageal Ring (Schatzki)) ESRD (End-Stage Kidney Disease) Essential Hypertension Essential Thrombocythemia (Primary Thrombocythemia) Essential Thrombocytosis (Primary Thrombocythemia) Essential Tremor [ezesauna.com]
Table 2 Signs & Symptoms Complications Apnoea Altered consciousness Cyanosis Hypoglycaemia Feeding problem Hypocalcaemia Vomiting Heperbilirubinaemia Irritability Necrotising enterocolitis Jitteriness Oliguria Tremor Haematuria Lethargy Renal vein thrombosis [lhp.leedsth.nhs.uk]
- Myoclonus
[…] movement Diminished or absent spontaneous movement Muscle tone Normal Mild hypotonia Flaccid Posture Mild distal flexion Strong distal flexion Intermittent decerebration Stretch reflexes Over-active Over-active, disinhibited Decreased or absent Segmental myoclonus [intranet.tdmu.edu.ua]
Workup
The clinical suspicion of polycythemia neonatorum is confirmed by venous hematocrit (>65%) or blood viscosity ( >12 centipoise) measurement. Additional tests should include complete cell blood count (could reveal thrombocytopenia [6] [7] as a consequence of localized thrombosis or disseminated intravascular coagulation), hypoglycemia, hypocalcemia [8], bilirubin level (high due to the high amount of bilirubin precursors). In addition, hypoxia stimulates peripheral release of young, nucleated red blood cells and reticulocytosis. Cyanotic infants may have decreased oxygenation demonstrated by arterial blood gas measurement. Maternal blood glucose should also be measured because the disease is more frequent in infants of diabetic mothers.
Urine analysis may reveal hematuria and proteinuria if renal vein thrombosis has occurred. A low glomerular filtration rate has also been described.
Postero-anterior thoracic radiography shows pulmonary congestion and cardiomegaly, therefore echocardiography is indicated in affected babies. This test will highlight the presence of decreased cardiac output and increased pulmonary resistance.
Symptomatic infants, as well as those whose hematocrit level is above 65% two hours after birth, should be evaluated in a dynamic manner, at 12 and 24 hours. Screening should be performed in children of diabetic mothers, small and large for gestational age infants and monochorionic twins [9]. In these cases, the disease should be suspected in utero, based on middle cerebral artery peak systolic velocity [10].
Serum
- Hypoglycemia
[…] for neonatal hypoglycemia and the incidence of hypoglycemia at risk category newborns. [tmj.ro]
Neurologic suffering is caused by low cerebral blood flow and impaired tissue metabolism due to hypoglycemia and hypocalcemia. [symptoma.com]
However, they found no difference between the incidences of hypoglycemia and severe hypoglycemia (need for IV glucose) between those two groups. In our study, severe hypoglycemia was more common among infants with a BW below −2 SDS. [frontiersin.org]
Other findings included hypoglycemia (40.0%) and hyperbilirubinemia (21.8%). Of the polycythemic infants, 14.5% had no clinical symptoms or associated laboratory abnormalities. [pediatrics.aappublications.org]
The labs are significant for mild hypoglycemia and a hematocrit of 72%. What is the most effective treatment for this patient's condition? QID: 102775 [step2.medbullets.com]
- Erythrocytes Increased
As the density of the erythrocytes increases they accumulate in the center of blood flow, and thrombocytes, which are lighter, migrate to periphery of the vascular wall (thrombocyte margination). [lhp.leedsth.nhs.uk]
- Hematocrit Increased
The abnormal increase in hematocrit increases the risk of hyperviscosity, microcirculatory hypoperfusion, and multisystem organ dysfunction [3]. [itmedicalteam.pl]
Treatment
Nevertheless, justification of this treatment is controversial. We evaluated the risk for short-term complications associated with a restrictive treatment protocol for neonatal polycythemia. [thieme-connect.com]
Ankylosing spondylitis - Current protocols for diagnosis and treatment options. Wegener granulomatosis - Autoimmune etiology and clinical course. [netdoc.com]
Treatment will depend on the level of red blood cells (hematocrit), as well as symptoms your baby has. Treatment may include observing your baby, giving him or her a normal amount of fluids and sugar (glucose), and periodic retesting. [saintlukeskc.org]
For use as adjunctive therapy with interferon for treatment of chronic hepatitis C For the treatment of the common cold For the treatment of hemoglobin SC disease For the treatment of migraines For the treatment of myeloproliferative disorders without [aetna.com]
Prognosis
Prevention, and Complications Prognosis good to very good in most individuals if untreated, adrenal crisis can lead to death within 1-6 weeks males usually have normal fertility; females may be abnormal fertility Prevention genetic counseling may help [medbullets.com]
Outlook (Prognosis) The outlook is good for infants with mild hyperviscosity. Good results are also possible in infants who receive treatment for severe hyperviscosity. The outlook will depend largely on the reason for the condition. [healthing.ca]
Usually good prognosis Spontaneous resolution is common Visual impairment if periorbital hemangioma is left untreated Some congenital infections may manifest with rashes or other skin conditions and should be differentiated from benign skin lesions in [amboss.com]
DESCRIPTION EPIDEMIOLOGY RISK FACTORS GENERAL PREVENTION PATHOPHYSIOLOGY DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES MEDICATION ISSUES FOR REFERRAL ONGOING CARE FOLLOW-UP RECOMMENDATIONS PROGNOSIS [5minuteconsult.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Wegener granulomatosis - Autoimmune etiology and clinical course. Diabetes - disease and management information, including diagnosis, typical treatment plans and diabetes supplies. [netdoc.com]
The etiology of polycythemia is related either to intrauterine hypoxia or secondary to fetal transfusion. Most polycythaemic infants are asymptomatic. Increased viscosity of blood may be associated with symptoms of hypoperfusion. [semanticscholar.org]
Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]
ONGOING CARE FOLLOW-UP RECOMMENDATIONS Patient Monitoring Periodic laboratory follow-up depending on the etiology of polycythemia. Monitor for the following: Headache, dizziness, or syncope Blurred visio... [5minuteconsult.com]
Epidemiology
Huang, MD and Tannie Huang, MD Reviewed 10/2018 BASICS DESCRIPTION EPIDEMIOLOGY RISK FACTORS GENERAL PREVENTION PATHOPHYSIOLOGY DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES MEDICATION [5minuteconsult.com]
Infantile hemangioma: Epidemiology update. J Am Acad Dermatol. 2013; 68 (4): p.AB95. doi: 10.1016/j.jaad.2012.12.395. | Open in Read by QxMD Al-Salem AH. Hemangiomas and Vascular Malformations. Atlas of Pediatric Surgery.. [amboss.com]
Key words: polycy<strong>the</strong>mia, hyperviscosity, partial exchange transfusion, <strong>newborn</strong> Definition and epidemiology <strong>Polycy<strong>the</strong>mia</strong> is described as a condition in which an increased red cell mass [yumpu.com]
Monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance appear to increase the risk of development of twin anemia-polycythemia sequence (TAPS), a form of TTTS, by nearly two-fold. [12] Epidemiology Polycythemia is a relatively [emedicine.medscape.com]
Pathophysiology
Huang, MD and Tannie Huang, MD Reviewed 10/2018 BASICS DESCRIPTION EPIDEMIOLOGY RISK FACTORS GENERAL PREVENTION PATHOPHYSIOLOGY DIAGNOSIS HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES MEDICATION [5minuteconsult.com]
Doyle JJ, Schmidt B, Blanchette V, Zipursky A: Hematology; in Avery GB, Fletcher MA, Mac Donald MG (eds): Neonatology: Pathophysiology and Management of the Newborn. Philadelphia, Lippincott Williams & Wilkins, 1999, pp 1045–1091. [karger.com]
Physiologic anemia of infancy Definition: a physiologic decrease in RBC production that typically appears at 8–12 weeks of age in term infants and 4–8 weeks of age in preterm infants Pathophysiology [34] Increase in oxygenation → ↑ in tissue oxygen levels [amboss.com]
The acquired form is more common, and pathophysiology has not been fully elucidated. [pathophys.org]
[edit] The pathophysiology of polycythemia varies based on its cause. [en.wikipedia.org]
Prevention
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [medicbind.com]
Neonatal Intensive Care Unit(NICU) Pediatrics Intensive Care Unit(PICU) Child Psychiatric Day Care Center Emergency Service (24 hours) Outpatient Service Pediatrics SPECIALTY/PRACTICE AREAS: • Pediatric pulmonology medicne • General pediatrics • Preventive [english.tmuh.org.tw]
[…] of Polycythemia neonatorum Yes, it may be possible to prevent Polycythemia neonatorum. [tabletwise.net]
Partial exchange transfusion is traditionally used as the method to lower the Hct and treat hyperviscosity; however, it is unclear whether this is an effective approach in preventing the long-term neurologic consequences. [ncbi.nlm.nih.gov]
References
- Rosenkrantz TS. Polycythemia and hyperviscosity in the newborn. Semin Thromb Hemost. 2003;29:515–27.
- Wiswell TE, Cornish JD, Northam RS. Neonatal polycythemia: Frequency of clinical manifestations and other associated findings. Pediatrics. 1986;78:26–30.
- Sarkar S, Rosenkrantz TS. Neonatal polycythemia and hyperviscosity. Semin Fetal Neonatal Med. 2008;13:248–255.
- Dempsey EM, Barrington K. Short and long term outcomes following partial exchange transfusion in the polycythaemic newborn: A systematic review. Arch Dis Child Fetal Neonatal Ed. 2006;91:F2–F6.
- Herson VC, Raye JR, Rowe JC, et al. Acute renal failure associated with polycythemia in a neonate. J Pediatr. 1982;100:137–139.
- Vlug RD, Lopriore E, Janssen M, et al. Thrombocytopenia in neonates with polycythemia: incidence, risk factors and clinical outcome. Expert Rev Hematol. 2015;8(1):123-129.
- Acunas B, Celtik C, Vatansever U, et al. Thrombocytopenia: An important indicator for the application of partial exchange transfusion in polycythemic newborn infants? Pediatr Int. 2000;42:343–347.
- Saggese G, Bertelloni S, Baroncelli GI, et al. Elevated calcitonin gene-related peptide in polycythemic newborn infants. Acta Paediatr. 1992;81:966–968.
- Oh W. Neonatal polycythemia and hyperviscosity. Pediatr Clin North Am 1986;33:523-532.
- Veujoz M, Sananès N, Severac F, et al. Evaluation of prenatal and postnatal diagnostic criteria for twin anemia-polycythemia sequence. Prenat Diagn. 2015;35(3):281-288.