Anaemia in the newborn

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Paediatrics (Haematological disorders) Mind Map on Anaemia in the newborn, created by v.djabatey on 19/03/2014.
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Mind Map by v.djabatey, updated more than 1 year ago
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Created by v.djabatey over 10 years ago
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Resource summary

Anaemia in the newborn
  1. reduced RBC prodn
    1. 2 main but rare causes
      1. both cause red cell aplasia
        1. low Hb
          1. RBCs look normal
            1. diagnostic clues
              1. low reticulocyte count
                1. normal bilirubin
              2. congenital infection w/ parvovirus B19
                1. congenital red cell aplasia (Diamond-Blackfan anaemia)
              3. increased RBC destruction (haemolytic anaemia)
                1. due to
                  1. antibody destroying RBCs (i.e. extrinsic cause)
                    1. immune causes
                      1. haemolytic disease of the newborn
                        1. aka immune haemolytic anaemia of newborn
                          1. caused by antibodies vs blood group antigens
                            1. most important antibodies
                              1. anti-D
                                1. anti-A
                                  1. anti-B
                                    1. anti-Kell
                                    2. mum is always -ve to the relevant antigen & baby always +ve
                                      1. mum makes antibodies vs baby's blood group
                                        1. mum's antibodies cross placenta into baby's circulation
                                          1. -> fetal or neonatal haemolytic anaemia
                                            1. diag using Coombs test (direct anti-globulin test)
                                              1. only +ve in antibody-mediated anaemias
                              2. intrinsic abnormality of surface or intracellular contents of RBCs
                                1. red cell mb disorders
                                  1. hereditary spherocytosis
                                  2. red cell enzyme disorders
                                    1. glucose-6-phosphate dehydrogenase deficiency
                                    2. abnormal haemoglobins
                                      1. alpha-thal major
                                        1. other haemoglobinopathies rarely present w/ sx in neontal period
                                          1. but detected on Guthrie test
                                    3. diagnostic clues
                                      1. raised reticulocyte count
                                        1. due to increased RBC prodn to compensate for anaemia
                                        2. raised unconjugated bilirubin
                                          1. due to increased RBC destruction w/ the bile pigment released into plasma
                                      2. blood loss
                                        1. feto-maternal haemorrhage
                                          1. occult bleeding into mum
                                          2. twin-to-twin transfusion
                                            1. bleeding from one twin into the other one
                                            2. blood loss around the time of delivery
                                              1. e.g. placental abruption
                                              2. diagnostic clues
                                                1. severe anaemia
                                                  1. raised reticulocyte count
                                                    1. normal bilirubin
                                                  2. anaemia of prematurity
                                                    1. inadequate erythropoietin productn
                                                      1. reduced RBC lifespan
                                                        1. frequent blood sampling whilst in hospital
                                                          1. Fe & folic acid deficiency (after 2-3 months)
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