الفهرس 
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Abstract
Summary hrombocytopenia can result from production insufficiency of the bone marrow or increased peripheral destruction. Examination of the bone marrow megakaryocytic pool is often required in order to quantify thrombopoiesis. Reticulated platelets are the youngest circulating platelets recently released from marrow megakaryocytes and contain abundant mRNA amounts. Increased percentage of reticulated platelets is a direct measure of young platelets and indicates increase platelet turnover. Flowcytometry has been proposed to evaluate platelet turnover by quantifying their RNA content. The current study was carried out on 30 thrombocytopenic neonates and 30 non thrombocytopenic neonates. Neonates were enrolled from NICU of Children’s Hospital, Ain Shams University. To evaluate the diagnostic usefulness of reticulated platelets in neonatal thrombocytopenic sepsis, their prognostic value and value in decrease the need for platelet transfusion. The neonates were classified as follows: Patients groups: 17 thrombocytopenic full term neonates with; their mean age was 11.71±4.13 days. 13 thrombocytopenic pre term neonates with; their mean age was 11.15±5.30 days. T
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Control groups: 16 nonthrombocytopenic full term neonates with; their mean age was 13.00±6.50 days. 14 non thrombocytopenic pre term neonates with; their mean age was 16.57±7.45days. All the patients and control were subjected to complete history, clinical examination and laboratory investigations including: 1. Complete blood picture with microscopic examination of peripheral blood film stained with Leishmans stain. 2. Qualitative measurement of C-reactive protein (CRP): the assay is performed by testing a suspension of latex particles coated with anti-human CRP antibodies against unknown serum. 3. Reticulated platelets percentage was measured by flowcytometry.
4. Calculation of absolute reticulated platelet count (ARP) (RP% x platelet count) in all samples.
5. Calculation of immature platelet fraction (IPF) in 1st sample (RP% / platelet count). The present study showed that the percentage of reticulated platelets in full term thrombocytopenic neonates was highly significant increased compared to full term non thrombocytopenic
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and preterm thorombocytopenic neonates was significantly increased when compared to preterm non thrombocytopenic neonates. As regard CRP in full term thrombocytopenic neonates was significantly increased when compared to full term non thrombocytopenic neonates and in preterm thrombocytopenic neonates was highly significantly increased when compared to preterm non thrombocytopenic neonates. A significant positive correlation was found between reticulated platelets percentage and duration till normalization of platelets among thrombocytopenic neonates , while there were non correlation detected between absolute reticulated platelets and duration till normalization of platelets among thrombocytopenic neonates. A significant positive correlation between reticulated platelets percentage and platelets count in thrombocytopenic fullterm neonates. A significant positive correlation between absolute
reticulated platelets and platelets count in thrombocytopenic preterm neonates. A significant negative correlation between immature platelets fraction and platelets count in non thrombocytopenic neonates.
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A significant negative correlation between reticulated platelets percentage and platelets count in non thrombocytopenic preterm neonates. In thrombocytopenic neonates reticulated platelets percentage and absolute reticulated platelets were found to be asignificant predictor as each unit increase in parameters had significant effect increase in platelets count. In non thrombocytopenic fulltrem neonates absolute
reticulated platelets was found to be significantly predictor as each unit increase in parameters had significant effect increase in platelets count. In non thrombocytopenic preterm neonates reticulated platelets percentage and absolute reticulated platelets were found to be significantly predictor as each unit increase in parameters had significant effect increase in platelets count.