Neonatal thrombocytopenic purpura in two infants.

Cases of purpura in the newborn have been recorded fairly frequently, and Robson and Walker (1951) have recently reviewed the literature of some 52 cases. Three types of congenital purpura are recognized: (1) Purpura when the mother is affected; (2) purpura when the mother is normal; (3) purpura associated with hypoplasia of the bone marrow. The essential characteristics in the diagnosis of idiopathic thrombocytopenic purpura in the adult are: (1) A platelet count of 100,000 or less; (2) no other cause for purpura; (3) normal clotting time; (4) prolonged bleeding time; (5) bone marrow normal or showing increased megakarocytes. The same criteria may be applied to neonatal cases. The literature shows over 30 such cases of congenital thrombocytopenic purpura occurring in the newborn in which the mother had the same disease, and amongst these McAlenney and Kristan (1949) found nine instances in which splenectomy had been performed on the mother. In the following account the mother had idiopathic thrombocytopenic purpura in 1938 when she was 15 years old, and both her infants, born in 1950 and in 1952, showed neonatal purpura.