Testing for platelet bleeding disorders in newborns and infants (less than one year old) poses a number of difficulties.

With the exception of electron microscopy, the methods used to test for HPS require a volume of blood too large to take from a newborn or small infant.  These methods include Lumi-aggregometry and Nucleotide assay.  Also, the blood platelets of newborns and infants below one year can behave differently to those of older children and adults. This means that test results may not be reliable and may need to be repeated at a later date.

The British Society for Haematology (BSH) recently published: ‘Guidelines for the Laboratory Investigation of Heritable Disorders of Platelet Function’ (Click here).  Testing for HPS is covered within the scope of the guidelines.  The guidelines state:

....... ’ Therefore the usual and pragmatic approach is to assess platelet function in children > 1 [over 1] year of age using adult controls and normal ranges (Hayward et al, 2010).’

Electron microscopy requires very much smaller volumes of blood than the other methods.  Some doctors might consider it to be appropriate in particular cases.  Parents should thoroughly discuss these issues with the medical team caring for their child.  Other evidence may be helpful in the decision to delay or undertake testing, eg: is there a family history of HPS or albinism, does the child in question have symptoms that indicate an underlying bleeding tendency, what are the potential risks of delaying testing weighed against the potential risks and difficulties of taking blood from a baby or small infant.

Testing for HPS in Babies and small infants