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Polycythemia of the Newborn Differential Diagnoses

  • Author: Karen J Lessaris, MD; Chief Editor: Ted Rosenkrantz, MD  more...
Updated: Jan 02, 2016

Diagnostic Considerations

Important considerations

Use of a blood product (eg, albumin) in an exchange transfusion may result in the transmission of infection. Infections related to blood products can be avoided by using normal saline, which is sterile and which has been shown to be as effective as albumin.

Informed consent must be obtained as exchange transfusions have multiple risks (see Treatment).

Umbilical partial exchange transfusion increases risk of necrotizing enterocolitis (NEC), especially if colloid is used.

No improvement in neurologic outcomes has been reported with partial exchange transfusion. However, polycythemia and neurologic abnormalities have been linked. Because of this, a symptomatic infant who has not been treated with partial exchange transfusion, and who subsequently develops neurologic abnormalities, may be considered inadequately treated.

Other problems to be considered

Method of blood draw

Capillary hematocrit (Hct) measurements depend on regional blood flow and can widely vary from central venous measurements, generally overestimating the central or true Hct level.

Iatrogenic problems

These may be related to transfusion or practice of delayed cord clamping.

Differential Diagnoses

Contributor Information and Disclosures

Karen J Lessaris, MD Clinical Faculty, Department of Pediatrics, Division of Neonatology, Carolinas Medical Center

Karen J Lessaris, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Brian S Carter, MD, FAAP Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Attending Physician, Division of Neonatology, Children's Mercy Hospital and Clinics; Faculty, Children's Mercy Bioethics Center

Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Pediatric Society, American Society for Bioethics and Humanities, American Society of Law, Medicine & Ethics, Society for Pediatric Research, National Hospice and Palliative Care Organization

Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine

Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, Eastern Society for Pediatric Research, American Medical Association, Connecticut State Medical Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

Scott S MacGilvray, MD Clinical Professor, Department of Pediatrics, Division of Neonatology, The Brody School of Medicine at East Carolina University

Scott S MacGilvray, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

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