Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis.

ABSTRACT

OBJECTIVE: In order to conclude on the megakaryopoietic activity during thrombocytopenia in sepsis or necrotizing enterocolitis (NEC), we analyzed the immature platelet fraction (IPF). STUDY DESIGN: Serial measurements of platelet counts and IPF in neonates with blood culture-proven late-onset sepsis (n=21) or surgical NEC (n=12) at T0 prior to the diagnosis of sepsis/NEC; T1 at diagnosis; T2 days 3 to 5 after onset; T3 days 8 to 12 after onset. RESULT: In parallel to declining platelet counts, the median absolute IPF significantly decreased between T0 and T2 in neonates with sepsis or NEC. We found a significant positive correlation between the platelet count and absolute IPF (r=0.71; P<0.001). In patients with low IPF (<2 per nl), the platelet count did not subsequently increase. Neonates with NEC who died exhibited significantly lower IPF compared with survivors (P<0.05). CONCLUSION: Low absolute IPF values during the course of neonatal sepsis/NEC suggest suppression of megakaryopoietic activity.