PDF(Pubmed)
Abstract：
We present a pediatric case of the antiplatelet effect of melatonin taken through breast milk in an 18-month-old child. The child was referred to our hematology outpatient clinic because of bleeding episodes that she presented since birth. Blood tests excluded the presence of blood coagulation diseases. The family history was negative for bleeding disorders. The child did not consume any drugs, food supplements, herbal teas or infusions. We performed an aggregation platelet test, which showed a reduced platelet aggregation. Shortly before, the baby had been breastfed. We speculated that breast milk could interfere with the result of the test; therefore, we decided to repeat the test in a fasting state. This time the test showed a normal platelet aggregation time. We learned that the child\'s mother was taking a mixture of valerian and melatonin. Thus, we decided to suspend maternal intake of melatonin and perform a new platelet aggregation test after three months. The test results were negative. After the suspension of melatonin, the patient did not present further bleeding events. In this case, melatonin, through the inhibition of platelet aggregation, had an important role on the hemostatic system of the child. Melatonin is considered as a dietary supplement and is mostly available as an alternative medicine without formal prescription and dosage regulation. It is important, especially during breastfeeding, to investigate personal and medication history, including also homeopathic remedies or dietary supplements.
摘要：
我们介绍了一个18个月大的儿童通过母乳摄取的褪黑激素的抗血小板作用的儿科病例。该孩子因出生后出现出血发作而被转诊到我们的血液科门诊。血液检查排除了凝血疾病的存在。家族史为出血性疾病阴性。孩子没有吸毒，食品补充剂,草药茶或输液。我们做了血小板聚集试验,显示血小板聚集减少。前不久,婴儿是用母乳喂养的。我们推测母乳会干扰检测结果，因此，我们决定在禁食状态下重复测试。这次测试显示正常的血小板聚集时间。我们了解到孩子的母亲正在服用缬草和褪黑激素的混合物。因此，我们决定在3个月后停止孕妇摄入褪黑素,并进行新的血小板聚集试验.测试结果为阴性。褪黑激素悬浮后，患者未出现进一步的出血事件.在这种情况下,褪黑激素,通过抑制血小板聚集，对孩子的止血系统有重要作用。褪黑激素被认为是一种膳食补充剂，并且大多数可以作为替代药物使用，而无需正式的处方和剂量调节。这很重要,尤其是在母乳喂养期间，调查个人和用药史，还包括顺势疗法或膳食补充剂。
