Two children with multiple severe disabilities due to brain destruction by neonatal infection had recurrent hypothermia (<34°C) with associated thrombocytopenia (<50,000), and clinical hemorrhage. They also had milder, less consistent erythroid and myeloid cell line abnormalities. The hypothermia was presumed to be due to hypothalamic dysfunction. Rewarming was always followed by correction of hematologic problems, but normal temperature was difficult to maintain. Recognition of this entity may improve long-term management of some severely disabled children.
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References
1.
Cohen IJ, Amir J., Gedaliah A., Rachmal A., Gorodischer R., Zaizov R.Thrombocytopenia of neonatal cold injury. J Pediatr1984;104:620-2.
2.
Easterbrook PJ, Davis HPThrombocytopenia in hypothermia: A common but poorly recognized complication. Br Med J1985;291:23.
Bjork VO, Hultquist G.Brain damage in children after deep hypothermia for open-heart surgery. Thorax1960; 15:284-91.
5.
Shenaq SA, Yawn DH, Saleem A., Joswiak R., Crawford ESEffect of profound hypothermia on leukocytes and platelets. Ann Clin Lab Sci1986;16:130-3.
6.
Sands MP, Mohri H., Sato S., Mannik M., Hessel EA, Dillard DHHematorheology during deep hypothermia. Cryobiology1979;16:229-39.
7.
Hessel EA, Schmer G., Dillard DHPlatelet kinetics during deep hypothermia. J Surg Res1980;28:23-34.
8.
O'Brien H., Amess Jal, Mollin DLRecurrent thrombocytopenia, erythroid hypoplasia and sideroblastic anaemia associated with hypothermia. Br J Haematol1982;51:451-6.
9.
Ellis PR, Kleinsasser LJ, Speer RJChanges in coagulation occurring in dogs during hypothermia and cardiac surgery . Surgery1957;41:198-210.
10.
Johansson BW , Nilsson IMThe effect of heparin and epsilon-aminocaproic acid on the coagulation in hypothermic dogs. Acta Physiol Scand1964;60:267-77.
11.
Mann TP, Elliott Rik.Neonatal cold injury. Lancet1957 2 Feb;1:229-34.
12.
Bower BD, Jones LF, Weeks MMCold injury in the newborn. Br Med J1960 30 Jan;1:303-9.
13.
Shapiro WR, Williams GH, Plum F.Spontaneous recurrent hypothermia accompanying agenesis of the corpus callosum . Brain1969;92:423-36.
14.
Summers GD, Young AC, Little RA, Stoner HB, ForbesWSTC, Jones RAC. Spontaneous periodic hypothermia with lipoma of the corpus callosum. J Neurol Neurosurg Psychiatry1981 ;44:1094-9.
15.
Mooradian AD , Morley GK, McGeachie R., Lundgren S., Morley JESpontaneous periodic hypothermia. Neurology1984;34:79-82.
16.
Carr-Locke D., Millac P.Diencephalic epilepsy in a patient with agenesis of the corpus callosum confirmed by computerized axial tomography. J Neurol Neurosurg Psychiatry1977;40:808-14.
17.
Ratcliffe PJ , Bell JI, Collins KJ, Frackowiak RS, Rudge P.Late onset post-traumatic hypothalamic hypothermia . J Neurol Neurosurg Psychiatry1983;46:72-4.
18.
Dick DJ, Sanders GL, Saunders M., Rawlins MDChronic hypothermia following tuberculous meningitis. J Neurol Neurosurg Psychiatry1981;44:255-7.
19.
Fox RH, Davies TW, Marsh FP, Urich H.Hypothermia in a young man with an anterior hypothalamic lesion. Lancet1970;2:185-8.
20.
Knutsen AP, Shah M., Schwarz KB, Tsai CCGraft versus host-like illness in a child with phenobarbital hypersensitivity . Pediatrics1986;78:581-4.
21.
The Pharmacological Basis of Therapeutics, 7th Ed. In: Gilman AG, Goodman LS, Rall TW, Murad F, eds. New York: MacMillan, 1985;357,455.
22.
Boas EP, Erf LAThrombocytopenic purpura following medication with sedormid and with phenobarbital . NY State J Med1936;36:491-4.