Thrombocytopenia and congenital syphilis in South African Bantu infants.

The causes of thrombocytopenia in the newborn and young infant differ from those of older children and adults. Maternal antibodies, platelet sequestration during haemolytic disease of the newborn, and thrombocytopenia following replacement transfusion with stored blood, bacterial septicaemia, and spirochaetal and protozoal infections are important causes of neonatal thrombocytopenic purpura. It may be a feature of the congenital aplastic anaemia associated with certain anomalies of bone, while in a proportion of cases the aetiology remains obscure. Syphilis as a cause of neonatal thrombocytopenia has not been emphasized and is either not mentioned in standard works of haematology (Britton, 1963; Wintrobe, 1961) or is cited as a rare association (Mandel, 1962). Our interest in the problem was first aroused by 2 cases of congenital syphilis associated with bleeding, thrombocytopenia, and anaemia. Although congenital syphilis is seen fairly frequently at Baragwanath Hospital, it was our impression that thrombocytopenia was rarely associated with this disease. A study was undertaken to assess the incidence of thrombocytopenia in syphilis, and to clarify the importance of syphilis as a cause of bleeding in newborn and young infants.