{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:52Z","timestamp":1756902172030,"version":"3.44.0"},"reference-count":46,"publisher":"The Pediatric Pharmacy Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019]]},"abstract":"Thrombocytopenia (platelet count <150 \u00d7 109<\/jats:sup>\/L) regularly occurs in newborns but is especially observed in critically ill neonates. We describe the case of a small for gestational age (SGA) neonate, who showed an unexpected, severe thrombocytopenia (8 \u00d7 109<\/jats:sup>\/L) at day 5 of life. The thrombocytopenia recovered completely after cessation of ranitidine (0.5 mg\/kg\/6 hr), which was started in a context of feeding difficulties. Other causes of neonatal thrombocytopenia were ruled out. Besides a brief report on a cimetidine-induced thrombocytopenia over 25 years ago, no other neonatal or pediatric cases of H2<\/jats:sub> antagonist-induced thrombocytopenia have been reported to date, although being widely used in routine care. Moreover, several adult cases have been published. In general, neonatal thrombocytopenia, although one of the most frequent hematological conditions in newborns, is only rarely attributed to an adverse drug reaction. Clinicians should be aware of the risks for adverse reactions, especially in routinely used drugs and in critically ill patients.<\/jats:p>","DOI":"10.5863\/1551-6776-24.1.66","type":"journal-article","created":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T18:43:51Z","timestamp":1551465831000},"page":"66-71","source":"Crossref","is-referenced-by-count":2,"title":["Ranitidine-induced Thrombocytopenia in a Neonate \u2013 A Case Report and Review of Literature"],"prefix":"10.5863","volume":"24","author":[{"given":"Levi","family":"Hoste","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"4","key":"i1551-6776-24-1-66-b1","series-title":"Blood Rev","first-page":"173","article-title":"Thrombocytopenia in the neonate","volume":"22","year":"2008","unstructured":"Roberts\n I\n , StanworthS, MurrayNA. \n Thrombocytopenia in the neonate. Blood Rev. 2008;22(4):173\u2013186."},{"issue":"3","key":"i1551-6776-24-1-66-b2","series-title":"Clin Perinatol","first-page":"655","article-title":"Evaluation and treatment of thrombocytopenia in the neonatal intensive care unit","volume":"27","year":"2000","unstructured":"Sola\n MC\n , Del VecchioA, RimszaLM. \n Evaluation and treatment of thrombocytopenia in the neonatal intensive care unit. Clin Perinatol. 2000;27(3):655\u2013679."},{"issue":"8","key":"i1551-6776-24-1-66-b3","series-title":"Early Hum Dev","first-page":"499","article-title":"Neonatal thrombocytopenia: What we do and don't know","volume":"84","year":"2008","unstructured":"Sola-Visner\n M\n , SaxonhouseMA, BrownRE. \n Neonatal thrombocytopenia: What we do and don't know. Early Hum Dev. 2008;84(8):499\u2013506."},{"issue":"2","key":"i1551-6776-24-1-66-b4","series-title":"Pediatrics","first-page":"e361","article-title":"Thrombocytopenia in small-for-gestational-age infants","volume":"136","year":"2015","unstructured":"Christensen\n RD\n , BaerVL, HenryE, \n et al. Thrombocytopenia in small-for-gestational-age infants. Pediatrics. 2015;136(2):e361\u2013e370."},{"issue":"4","key":"i1551-6776-24-1-66-b5","series-title":"Vox Sang","first-page":"361","article-title":"Early-onset thrombocytopenia in near-term and term infants with perinatal asphyxia","volume":"106","year":"2014","unstructured":"Boutaybi\n N\n , SteggerdaSJ, Smits-WintjensVEHJ, \n et al. Early-onset thrombocytopenia in near-term and term infants with perinatal asphyxia. Vox Sang. 2014;106(4):361\u2013367."},{"issue":"3","key":"i1551-6776-24-1-66-b6","series-title":"J Clin Neonatol","first-page":"131","article-title":"Hypoxia as a predisposing factor for the development of early onset neonatal thrombocytopenia","volume":"1","year":"2012","unstructured":"Nadkarni\n J\n , PatneS, KispottaR. \n Hypoxia as a predisposing factor for the development of early onset neonatal thrombocytopenia. J Clin Neonatol. 2012;1(3):131\u2013134."},{"issue":"8634","key":"i1551-6776-24-1-66-b7","series-title":"Lancet","first-page":"363","article-title":"348 cases of suspected neonatal alloimmune thrombocytopenia","volume":"1","year":"1989","unstructured":"Mueller-Eckhardt\n C\n , KiefelV, GrubertA, \n et al. 348 cases of suspected neonatal alloimmune thrombocytopenia. Lancet. 1989;1(8634):363\u2013366."},{"issue":"12","key":"i1551-6776-24-1-66-b8","series-title":"Blood","first-page":"4402","article-title":"Frequency of immune thrombocytopenia in newborns: a prospective study. Immune Thrombocytopenia Working Group","volume":"89","year":"1997","unstructured":"Dreyfus\n M\n , KaplanC, VerdyE, \n et al. Frequency of immune thrombocytopenia in newborns: a prospective study. Immune Thrombocytopenia Working Group. Blood. 1997;89(12):4402\u20134406."},{"issue":"1","key":"i1551-6776-24-1-66-b9","series-title":"Transfus Med","first-page":"35","article-title":"Platelet transfusion in the management of severe thrombocytopenia in neonatal intensive care unit patients","volume":"12","year":"2002","unstructured":"Murray\n NA\n , HowarthLJ, McCloyMP, \n et al. Platelet transfusion in the management of severe thrombocytopenia in neonatal intensive care unit patients. Transfus Med. 2002;12(1):35\u201341."},{"issue":"5","key":"i1551-6776-24-1-66-b10","series-title":"Eur J Haematol","first-page":"421","article-title":"Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages","volume":"84","year":"2010","unstructured":"Royer\n DJ\n , GeorgeJN, TerrellDR. \n Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages. Eur J Haematol. 2010;84(5):421\u2013429."},{"issue":"12","key":"i1551-6776-24-1-66-b11","series-title":"Pediatr Blood Cancer","first-page":"1975","article-title":"Drug-induced thrombocytopenia in children","volume":"60","year":"2013","unstructured":"Reese\n JA\n , NguyenLP, BuchananGR, \n et al. Drug-induced thrombocytopenia in children. Pediatr Blood Cancer. 2013;60(12):1975\u20131981."},{"issue":"4","key":"i1551-6776-24-1-66-b12","series-title":"La Tunisie medicale","first-page":"305","article-title":"Prevalence and outcomes of thrombocytopenia in a neonatal intensive care unit","volume":"94","year":"2016","unstructured":"Dahmane Ayadi\n I\n , Ben HamidaE, YoussefA, \n et al. Prevalence and outcomes of thrombocytopenia in a neonatal intensive care unit. La Tunisie medicale. 2016; 94(4):305\u2013308."},{"issue":"5","key":"i1551-6776-24-1-66-b13","series-title":"PLoS One","first-page":"e0154853","article-title":"Early-onset thrombocytopenia in small-for-gestational-age neonates: a retrospective cohort study","volume":"11","year":"2016","unstructured":"Fustolo-Gunnink\n SF\n , VlugRD, Smits-WintjensVEHJ, \n et al. Early-onset thrombocytopenia in small-for-gestational-age neonates: a retrospective cohort study. PLoS One. 2016;11(5):e0154853."},{"issue":"1","key":"i1551-6776-24-1-66-b14","series-title":"AJP Rep","first-page":"e42","article-title":"Neonatal thrombocytopenia as a consequence of maternal preeclampsia","volume":"6","year":"2015","unstructured":"Kalagiri\n R\n , ChoudhuryS, CarderT, \n et al. Neonatal thrombocytopenia as a consequence of maternal preeclampsia. AJP Rep. 2015;6(1):e42\u2013e47."},{"issue":"4","key":"i1551-6776-24-1-66-b15","series-title":"Intensive Care Med","first-page":"459","article-title":"H2 Antagonist-induced thrombocytopenia: is this a real phenomenon?","volume":"28","year":"2002","unstructured":"Wade\n EE\n , RebuckJA, HealeyMA, \n et al. H2 Antagonist-induced thrombocytopenia: is this a real phenomenon?Intensive Care Med. 2002;28(4):459\u2013465."},{"issue":"2","key":"i1551-6776-24-1-66-b16","series-title":"Clin Pharmacol Ther","first-page":"239","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","year":"1981","unstructured":"Naranjo\n CA\n , BustoU, SellersEM, \n et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239\u2013245."},{"issue":"11","key":"i1551-6776-24-1-66-b17","series-title":"Ann Intern Med","first-page":"886","article-title":"Drug-induced thrombocytopenia: a systematic review of published case reports","volume":"129","year":"1998","unstructured":"George\n JN\n , RaskobGE, ShahSR, \n et al. Drug-induced thrombocytopenia: a systematic review of published case reports. Ann Intern Med. 1998;129(11):886\u2013890."},{"issue":"11","key":"i1551-6776-24-1-66-b18","series-title":"Nephrol Dial Transplant","first-page":"2376","article-title":"Dose-reducing H2 receptor antagonists in the presence of low glomerular filtration rate: a systematic review of the evidence","volume":"20","year":"2005","unstructured":"Manlucu\n J\n , TonelliM, RayJG, \n et al. Dose-reducing H2 receptor antagonists in the presence of low glomerular filtration rate: a systematic review of the evidence. Nephrol Dial Transplant. 2005;20(11):2376\u20132384."},{"issue":"4","key":"i1551-6776-24-1-66-b19","series-title":"Br J Clin Pharmacol","first-page":"788","article-title":"Adverse drug reactions in neonates and infants: a population-tailored approach is needed","volume":"80","year":"2015","unstructured":"Allegaert\n K\n , van den AnkerJN. \n Adverse drug reactions in neonates and infants: a population-tailored approach is needed. Br J Clin Pharmacol. 2015;80(4):788\u2013795."},{"issue":"1","key":"i1551-6776-24-1-66-b20","series-title":"J Clin Pharmacol","first-page":"87","article-title":"An algorithm to detect adverse drug reactions in the neonatal intensive care unit","volume":"53","year":"2013","unstructured":"Du\n W\n , LehrVT, Lieh-LaiM, \n et al. An algorithm to detect adverse drug reactions in the neonatal intensive care unit. J Clin Pharmacol. 2013;53(1):87\u201395."},{"issue":"6","key":"i1551-6776-24-1-66-b21","series-title":"Clin Pharmacol Ther","first-page":"725","article-title":"Adverse drug reactions in children: the double-edged sword of therapeutics","volume":"101","year":"2017","unstructured":"Elzagallaai\n A\n , GreffM, RiederM. \n Adverse drug reactions in children: the double-edged sword of therapeutics. Clin Pharmacol Ther. 2017;101(6):725\u2013735."},{"issue":"3\u20134","key":"i1551-6776-24-1-66-b22","series-title":"Dev Pharmacol Ther","first-page":"173","article-title":"Epidemiology of adverse drug reactions in the newborn","volume":"5","year":"1982","unstructured":"Aranda\n JV\n , Portuguez-MalavasiA, CollingeJM, \n et al. Epidemiology of adverse drug reactions in the newborn. Dev Pharmacol Ther. 1982;5(3\u20134):173\u2013184."},{"issue":"2","key":"i1551-6776-24-1-66-b23","series-title":"Pediatrics","first-page":"555","article-title":"Adverse drug reactions among children over a 10-year period","volume":"118","year":"2006","unstructured":"Le\n J\n , NguyenT, LawAV, HoddingJ. \n Adverse drug reactions among children over a 10-year period. Pediatrics. 2006;118(2):555\u2013562."},{"issue":"2","key":"i1551-6776-24-1-66-b24","series-title":"Paediatr Drugs","first-page":"153","article-title":"Incidence, preventability, and impact of adverse drug events (ADEs) and potential ADEs in hospitalized children in New Zealand: a prospective observational cohort study","volume":"11","year":"2009","unstructured":"Kunac\n DL\n , KennedyJ, AustinN, \n et al. Incidence, preventability, and impact of adverse drug events (ADEs) and potential ADEs in hospitalized children in New Zealand: a prospective observational cohort study. Paediatr Drugs. 2009;11(2):153\u2013160."},{"issue":"4","key":"i1551-6776-24-1-66-b25","series-title":"Arc Dis Child","first-page":"371","article-title":"Adverse drug reactions in neonates: a prospective study","volume":"101","year":"2016","unstructured":"Bel\u00e9n Rivas\n A\n , ArruzaL, PachecoE, \n et al. Adverse drug reactions in neonates: a prospective study. Arc Dis Child. 2016;101(4):371\u2013376."},{"issue":"4","key":"i1551-6776-24-1-66-b26","series-title":"Br J Clin Pharmacol","first-page":"1058","article-title":"Neonatal adverse drug reactions: an analysis of reports to the French pharmacovigilance database","volume":"82","year":"2016","unstructured":"Kaguelidou\n F\n , Beau-SalinasF, Jonville-BeraAP, \n et al. Neonatal adverse drug reactions: an analysis of reports to the French pharmacovigilance database. Br J Clin Pharmacol. 2016;82(4):1058\u20131068."},{"issue":"4","key":"i1551-6776-24-1-66-b27","series-title":"Drug Metab Pers Ther","first-page":"235","article-title":"Vancomycin-induced thrombocytopenia in a newborn","volume":"31","year":"2016","unstructured":"Kalra\n K\n , MittalHG, MariaA. \n Vancomycin-induced thrombocytopenia in a newborn. Drug Metab Pers Ther. 2016;31(4):235\u2013237."},{"issue":"4","key":"i1551-6776-24-1-66-b28","series-title":"Pharmacology","first-page":"285","article-title":"A newborn with vancomycin-induced thrombocytopenia","volume":"82","year":"2008","unstructured":"Dilli\n D\n , O\u011fuzSS, DilmenU. \n A newborn with vancomycin-induced thrombocytopenia. Pharmacology. 2008;82(4):285\u2013286."},{"issue":"12","key":"i1551-6776-24-1-66-b29","series-title":"Indian J Pediatr","first-page":"1278","article-title":"Pantoprazole-induced thrombocytopenia","volume":"76","year":"2009","unstructured":"Miller\n JL\n , GormleyAK, JohnsonPN. \n Pantoprazole-induced thrombocytopenia. Indian J Pediatr. 2009;76(12):1278\u20131279."},{"issue":"3","key":"i1551-6776-24-1-66-b30","series-title":"Pediatrics","first-page":"595","article-title":"Continuous infusion of glucagon induces severe hyponatremia and thrombocytopenia in a premature neonate","volume":"107","year":"2001","unstructured":"Belik\n J\n , MuseyJ, TrussellRA. \n Continuous infusion of glucagon induces severe hyponatremia and thrombocytopenia in a premature neonate. Pediatrics. 2001;107(3):595\u2013597."},{"issue":"7","key":"i1551-6776-24-1-66-b31","series-title":"Ann Hematol","first-page":"961","article-title":"Thrombocytopenia in neonates: causes and outcomes","volume":"92","year":"2013","unstructured":"Ulusoy\n E\n , T\u00fcfek\u00e7i\u00d6, DumanN, \n et al. Thrombocytopenia in neonates: causes and outcomes. Ann Hematol. 2013;92(7):961\u2013967."},{"issue":"5","key":"i1551-6776-24-1-66-b32","series-title":"Am J Perinatol","first-page":"399","article-title":"Treatment of patent ductus arteriosus: indomethacin or ibuprofen?","volume":"27","year":"2010","unstructured":"Linder\n N\n , BelloR, HernandezA, \n et al. Treatment of patent ductus arteriosus: indomethacin or ibuprofen?Am J Perinatol. 2010;27(5):399\u2013404."},{"issue":"1","key":"i1551-6776-24-1-66-b33","series-title":"Br J Clin Pract","first-page":"51","article-title":"Ibuprofen-induced thrombocytopenia","volume":"48","year":"1994","unstructured":"Jain\n S\n . \n Ibuprofen-induced thrombocytopenia. Br J Clin Pract. 1994;48(1):51."},{"issue":"1","key":"i1551-6776-24-1-66-b34","series-title":"J Pediatr Surg","first-page":"112","article-title":"Analysis of outcome in 298 extremely low-birth-weight infants with patent ductus arteriosus","volume":"44","year":"2009","unstructured":"Alexander\n F\n , ChiuL, KrohM, \n et al. Analysis of outcome in 298 extremely low-birth-weight infants with patent ductus arteriosus. J Pediatr Surg. 2009;44(1):112\u2013117."},{"issue":"20","key":"i1551-6776-24-1-66-b35","series-title":"N Engl J Med","first-page":"1330","article-title":"Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin","volume":"332","year":"1995","unstructured":"Warkentin\n TE\n , LevineMN, HirshJ, \n et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332(20):1330\u20131336."},{"issue":"5","key":"i1551-6776-24-1-66-b36","series-title":"Neonatal Netw","first-page":"33","article-title":"Heparin-induced thrombocytopenia in neonates","volume":"24","year":"2005","unstructured":"Martchenke\n J\n , BoshkovL. \n Heparin-induced thrombocytopenia in neonates. Neonatal Netw. 2005;24(5):33\u201337."},{"issue":"1","key":"i1551-6776-24-1-66-b37","series-title":"J Pediatr Pharmacol Ther","first-page":"12","article-title":"Heparin-induced thrombocytopenia in the pediatric population: a review of current literature","volume":"17","year":"2012","unstructured":"Vakil\n NH\n , KanaanAO, DonovanJL. \n Heparin-induced thrombocytopenia in the pediatric population: a review of current literature. J Pediatr Pharmacol Ther. 2012;17(1):12\u201330."},{"issue":"2","key":"i1551-6776-24-1-66-b38","series-title":"J Vasc Surg","first-page":"306","article-title":"Heparin-induced thrombocytopenia in the newborn","volume":"15","year":"1992","unstructured":"Spadone\n D\n , ClarkF, JamesE, \n et al. Heparin-induced thrombocytopenia in the newborn. J Vasc Surg. 1992;15(2):306\u2013311."},{"issue":"2","key":"i1551-6776-24-1-66-b39","series-title":"Ann Pharmacother","first-page":"229","article-title":"Lepirudin use in a neonate with heparin-induced thrombocytopenia","volume":"37","year":"2003","unstructured":"Nguyen\n TN\n , GalP, RansomJL, \n et al. Lepirudin use in a neonate with heparin-induced thrombocytopenia. Ann Pharmacother. 2003;37(2):229\u2013233."},{"issue":"5","key":"i1551-6776-24-1-66-b40","series-title":"Arch Dis Child","first-page":"337","article-title":"Cows' milk allergy in the syndrome of thrombocytopenia with absent radius","volume":"51","year":"1976","unstructured":"Whitfield\n MF\n , BarrDG. \n Cows' milk allergy in the syndrome of thrombocytopenia with absent radius. Arch Dis Child. 1976;51(5):337\u2013343."},{"issue":"9","key":"i1551-6776-24-1-66-b41","series-title":"Arch Dis Child","first-page":"744","article-title":"Congenital thrombocytopenia and milk allergy","volume":"52","year":"1977","unstructured":"Jones\n RH\n . \n Congenital thrombocytopenia and milk allergy. Arch Dis Child. 1977;52(9):744\u2013745."},{"issue":"9","key":"i1551-6776-24-1-66-b42","series-title":"Am J Perinatol","first-page":"811","article-title":"Medication use in the neonatal intensive care unit","volume":"31","year":"2014","unstructured":"Hsieh\n EM\n , HornikCP, ClarkRH, \n et al. Medication use in the neonatal intensive care unit. Am J Perinatol. 2014;31(9):811\u2013821."},{"issue":"6","key":"i1551-6776-24-1-66-b43","series-title":"Pediatrics","first-page":"1979","article-title":"Reported medication use in the neonatal intensive care unit: data from a large national data set","volume":"117","year":"2006","unstructured":"Clark\n RH\n , BloomBT, SpitzerAR, \n et al. Reported medication use in the neonatal intensive care unit: data from a large national data set. Pediatrics. 2006;117(6):1979\u20131987."},{"issue":"1","key":"i1551-6776-24-1-66-b44","series-title":"Eur J Clin Pharmacol","first-page":"87","article-title":"Drug utilisation on a preterm and neonatal intensive care unit in Germany: a prospective, cohort-based analysis","volume":"66","year":"2010","unstructured":"Neubert\n A\n , LukasK, LeisT, \n et al. Drug utilisation on a preterm and neonatal intensive care unit in Germany: a prospective, cohort-based analysis. Eur J Clin Pharmacol. 2010;66(1):87\u201395."},{"issue":"12","key":"i1551-6776-24-1-66-b45","series-title":"Eur J Clin Pharmacol","first-page":"1263","article-title":"Drug utilisation pattern and off-label use of medicines in Estonian neonatal units","volume":"67","year":"2011","unstructured":"Lass\n J\n , K\u00e4\u00e4rR, J\u00f5giK, \n et al. Drug utilisation pattern and off-label use of medicines in Estonian neonatal units. Eur J Clin Pharmacol. 2011;67(12):1263\u20131271."},{"issue":"8","key":"i1551-6776-24-1-66-b46","series-title":"Arch Dis Child","first-page":"998","article-title":"Ranitidine in the newborn","volume":"63","year":"1988","unstructured":"Habel\n A\n , MurrayN. \n Ranitidine in the newborn. Arch Dis Child. 1988;63(8):998."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/24\/1\/article-p66.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/24\/1\/66\/1786122\/1551-6776-24_1_66.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/24\/1\/article-p66.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/24\/1\/article-p66.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:40:41Z","timestamp":1747356041000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/24\/1\/article-p66.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":46,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-24.1.66","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2019]]}}}