4th Pediatric Infectious Diseases Conference
 
 
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Specialist Answers
Question
I have a patient one month old with testicualt torsion. The values of the AFP are more than 1000 microgram/l I have no experience with AFP on newborn children.
Answer
Alpha -Fetoprotein (AFP) is a single chain -globulin with a molecular weight of ~70 000. AFP is produced in the developing fetus by both the yolk sac and the fetal liver. At 12 weeks after conception the yolk sac degenerates and the fetal liver becomes the main site of synthesis. After 14 weeks of gestation (peak value of AFP), AFP synthesis decreases until parturition (1). The observation that AFP synthesis does not entirely cease at birth may be explained on the basis of transient production sustained by the presence of fetal hepatocytes
In a Thai study it was found that the premature neonates had alpha fetoprotein levels of 92,200+-54,496 ng/ml and term neonates had 50,283+-43,171 ng/ml. The levels progressively declined and approached the adult level at 6-9 months of age.

REF:
1. Blair JI, Carachi R, Gupta R, Sim FG, Macallister EJ, Weston R. Plasma -fetoprotein reference ranges in infancy: effect of prematurity. Arch Dis Child 1987;62:362-369.
2. Chulalongkorn Medical Journal 1989 Sep; 33(9): 675-8
 
 
 
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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?
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