title: Hematologic disorders following prolonged use of intravenous fat emulsions in children.
abstract: Abnormalities in hematologic parameters, associated with prolonged utilization of intravenous fat emulsion (IVFE), were observed in seven children on long-term cyclic total parenteral nutrition (TPN). All patients were receiving IVFE (Intralipid 20%) 1 to 2 g/kg/24 hr as part of TPN, during 3 to 18 months. Recurrent thrombocytopenia occurred in all seven patients. Platelet lifespan, as measured with 111 Indium was reduced. Sea-blue histiocytes containing granulations and hemophagocytosis were seen on bone marrow smears. Scans taken after injection of autologous erythrocytes labeled with technetium-99 showed bone marrow sequestration of these cells. Taken together, this constellation of hematologic abnormalities suggests that long-term IVFE administration induces hyperactivation of the monocyte-macrophage system.
mesh_terms: D000293:Adolescent; D001792:Blood Platelets / Q000502:physiology; D001853:Bone Marrow / Q000648:ultrastructure; D002470:Cell Survival; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000502:physiology; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects*; D005260:Female; D006402:Hematologic Diseases / Q000209:etiology*; D006434:Hemocytes / Q000502:physiology; D006644:Histiocytes / Q000648:ultrastructure; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D010587:Phagocytosis; D010958:Plasminogen / Q000378:metabolism; D010960:Plasminogen Activators / Q000097:blood; D012008:Recurrence; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D005217:Fat Emulsions, Intravenous; D010958:Plasminogen; D010960:Plasminogen Activators