Maternal Immune Thrombocytopenia With Prior Splenectomy as a Cause of Severe Neonatal Thrombocytopenia: A Case Report.

Severe neonatal thrombocytopenia is a formidable complication of maternal immune thrombocytopenic purpura (ITP). We report the case of a male newborn, preterm at 32 weeks of gestation, presenting on day 4 of life with jaundice and severe cutaneous hemorrhagic syndrome. The maternal history was significant for severe ITP requiring splenectomy. The initial assessment showed a significant drop in platelets, with a count of 6,000/mm³, even though the bone marrow aspirate appeared normal. Treatment included corticosteroids, platelet transfusions, polyvalent immunoglobulins, and phototherapy. This approach led to a gradual improvement, and the platelet count returned to normal within three months. This case highlights the association between the severity of maternal ITP and the risk of severe neonatal thrombocytopenia. It also emphasizes the importance of a thorough, team-based treatment plan that combines treatments to relieve symptoms with immunomodulatory therapies.