To characterize the immune profile of neonates with Kasabach-Merritt phenomenon (KMP) and identify clinical features linked to severe thrombocytopenia.
Approach:
Study Design: Multicenter retrospective study including neonates diagnosed with KMP based on established criteria.
Comparative Analysis: Compared peripheral blood lymphocyte subsets, complement levels, and humoral immunity between KMP neonates and controls.
Group Division: KMP neonates were divided into severe and non-severe groups based on platelet count.
Data Comparison: Clinical data and treatment outcomes were compared between the two groups, with multivariate analysis for independent factors.
Key Findings:
KMP neonates had reduced CD3+CD4+ and CD3−CD19+ proportions and lower IgG levels (all P < 0.05) compared to controls.
The most common KHE lesion type was superficial + mixed (24/32, 75.00%), with a median maximum diameter of 68.50 (52.50–87.25) mm.
The severe KMP group had larger diameters, lower CD3+CD4+ proportions, and higher levels of lymphocytes percentage, PCT, CKMB, and ferritin (all P < 0.05).
Prolonged APTT and elevated ferritin were identified as independently associated with severe thrombocytopenia (P < 0.05).
Interpretation:
Neonates with KMP exhibited immunological abnormalities, including decreases in helper T cells and B cells, as evidenced by the reduced proportions of CD3+CD4+ and CD3−CD19+ cells.
Limitations:
Study is retrospective and may have selection bias.
Limited sample size may affect the generalizability of findings.
Conclusion:
Prolonged APTT and elevated ferritin were identified as significant risk factors for severe thrombocytopenia in neonates with KMP.
