Congenital and neonatal thrombocytopenic purpura.

Haemorrhagic disease due to a deficiency of blood platelets is stated to be a very rare condition in the newborn. Considerable interest has been shown in the condition recently, however, and examples are being reported with increasing frequency. Barclay (1945), Schefrin and Shechtman (1945), Waters (1946), and Landolt (1948) all review small series of cases; McAlenney and Kristan (1949) collected and reviewed a total of 34 cases, adding a further six examples of their own. A survey of the world's literature shows that in fact some 52 cases of thrombocytopenic purpura in the neonatal period have now been reported.* We have recently encountered three further examples of this condition. The features of these three cases differed so markedly as to suggest that the haemorrhagic tendency was due to different causes. It seemed desirable therefore to review and classify the previously reported cases of thrombocytopenia in the newborn. Such a classification has not previously been made, apart from a suggestion by landolt (1948) that there were three forms of congenital thrombocytopenia; one associated with maternal purpura, one in which there was no maternal disorder, and a third type in which there was congenital hypoplasia of the bone marrow. It must be pointed out that purpura is not a disease entity, but a sign of a bleeding tendency, which may be due to platelet deficiency, capillary disorder, or a defect in blood coagulation. A haemorrhagic state associated with thrombocytopenia is the condition primarily under discussion in this paper.