Neonatal thrombocytopenia comprises a platelet count of less than 150×109/L, with severe neonatal thrombocytopenia in case of a platelet count less than 50×109/L. Severe thrombocytopenia is an uncommon finding in newborns requiring immediate diagnostic work-up with the need for urgent intervention to avoid severe bleeding complications. Neonatal thrombocytopenia can be classified by time of onset in early-onset (<72h after birth) versus late-onset (>72h after birth) thrombocytopenia. Multiple causes may be involved. In term, otherwise healthy neonates, one important cause of early-onset thrombocytopenia is antibody-mediated platelet destruction, and this can be allo- or auto-immune-mediated. In this case presentation, we discuss two neonates with severe early-onset immune-mediated thrombocytopenia presenting simultaneously at our general hospital.

(BELG J HEMATOL 2016;7(5):188–93)