Key Points Renal organogenesis is a complex interaction between gene stimulation of planned growth and complementary apoptosis, allowing appropriate development of the functioning renal organ system, vascular bed, and intertwined genital system. The renin-angiotensin system (RAS) is critical to normal…
Key Points The spectrum of malignancies in neonates differs from that in children. Malignancies in neonates are often associated with a genetic predisposition. Neuroblastoma and leukemia are the most common malignancies in neonates. Cancer treatment in neonates poses unique challenges,…
Key Points Early clinical jaundice or rapidly developing hyperbilirubinemia is often a sign of hemolysis, the differential diagnosis of which commonly includes immune-mediated disorders, red cell enzyme deficiencies, and red cell membrane defects. Knowledge of the maternal blood type and…
Key Points The neonate and the young infant depend primarily on the innate immune system for host defense. With limited prior exposure to infectious and environmental antigens, the adaptive immune arm is still in a phase of structural and functional…
Key Points Recent multicenter randomized trials support more conservative transfusion approaches with the use of lower hemoglobin and platelet count thresholds. Two multicenter clinical trials did not show improvement in survival without neurodevelopmental impairment or other important outcomes with the…
Key Points Erythropoiesis occurs in stages or waves during embryonic development, initiating in the yolk sac, migrating to the liver, and finally to the bone marrow. The sites of erythropoietin production also transition during development from the neuronal cells to…
Key Points The most common cause of mild to moderate, early-onset thrombocytopenia in well-appearing neonates is placental insufficiency, frequently manifesting as small-for-gestational status at birth. This thrombocytopenia resolves spontaneously, usually within 10 days, and carries good prognosis. Thrombocytopenia in sick…
Key Points Acquired or inherited coagulation disorders should be considered in any neonate that suffers significant hemorrhage. Treatment for specific coagulation disorders should be provided in consultation with pediatric hematology and based on the most current guidelines. Thromboembolism (TE) is…
Key Points Pluripotential stem cells sustain hematopoietic function throughout a person's lifetime; the fate of developing cells is influenced by the microenvironment. The site of erythropoiesis changes over development, progressing from the yolk sac to the aortogonadomesonephron, to the liver,…
Key Points Early onset (<24 hours of age) or new jaundice is never normal and should be investigated. Initial evaluation of a jaundiced infant should always include conjugated and unconjugated bilirubin levels. Infants presenting with jaundice secondary to conjugated hyperbilirubinemia…