A. Monsef et al. / Health 3 (2011) 709-711
Copyright © 2011 SciRes. Openly accessible at http:// www.scirp.org/journal/HEALTH/
711711
therapy and hyperbilirubinemia [4,10,12]. The cause of
thrombocytopenia had not clearly defined, probably de-
struction of platelet in cutaneous microvasculature ex-
posed to phototherapy has a major role [12]. It is con-
comitant with Maurer et al. experience. They had ex-
posed plasma rich platelet to blue fluorescent light for 110
minutes and by electron microscope. They observed de-
crease in glycogen granules, platelet swelling and de-
formity [9]. In another research they had reported in-
creased platelet turn over during low birth weight (LBW)
neonate’s phototherapy for 96-hour period. Regarding to
low platelet reserve in LBW neonates bon marrow, the
increased turn over results to thrombocytopenia [13].
However Karim et al. in a study in 1981 showed that
phototherapy did not have any effect on platelets [6].
Photodynamic damage on platelets had studied by Tozzi-
Ciancar et al. via measuring LDH level [14]. They ex-
posed platelets rich plasma to visible light and measured
LDH level after 2 hours. They found 20% increase of
LDH level and they explained that it is due to photody-
namic side effect associated with hyperbilirubinemia on
platelets [14]. In a study Sakha et al. at 2007, on 150 full
terms, healthy neonates that hospitalized for treatment of
hyperbilirubinemia, showed increase of platelets and
white blood cells (WBC) during Phototherapy. Accord-
ing to their study increase of WBC correlate with patient
age and increase platelet count related to phototherapy
duration [7]. In another study on 101 newborn, Pishva et
al. showed 49.5% thrombocytopenia in treated patients.
They concluded increased platelet turnover and damage
during phototherapy as the responsible mechanism [8]. In
our study the newborns were full term with adequate plate-
let reserve. Increased platelet turnover and release of bone
marrow seems to be responsible mechanism for platelet
count rise. Although we find a meaningful difference (P =
0.015) in platelet count before and after phototherapy, but it
was in the normal reference range and we did not have any
bleeding tendency nor hyper-coagulability state in them. It
was not accessible for us to mesure thrombopoetin in this
study, so we propose it to other researchers. The limitations
of this study was lack of high technology cell counter
based on flowcy-tometry evaluation.
5. CONCLUSIONS
Present study state the hypothesis that phototherapy in
full term icteric newborns leads to rise in platelet count.
This may be due to accelerated platelet turnover in peri-
pheral microvasculature with adequate platelet reserve in
marrow. Based on our results and controversial studies,
platelet count measuring before and after phototherapy is
suggested as a routine protocol. Also more future multi
centric and case-control studies in preterm and full term
newborns should be done to evaluate this hypothesis.
6. ACKNOWLEDGEMENTS
The authors would like to acknowledge the office of Vice chancellor
for research of Hamadan University of Medical Sciences for financial
support of this study. Also we would like to thank Dr M. Fallah for his
assistance in statistical analysis, Dr S. Shabani and staff of neonatal
ward for their contribution and collaboration.
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