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Neonatal alloimmune thrombocytopaenia associated with maternal HLA antibodies

Wendel, Kristina; Akkök, Çiǧdem Akalin and Kutzsche, Stefan (2017) In BMJ Case Reports 2017.
Abstract

Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum. Weak antibodies against HLA-B57 and HLA-B58 in sera from both twins supported NAIT as the most likely diagnosis. Platelet transfusion... (More)

Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum. Weak antibodies against HLA-B57 and HLA-B58 in sera from both twins supported NAIT as the most likely diagnosis. Platelet transfusion requirements of the twins lasted for 7 weeks. Transfusion of HLA-matched platelet concentrates was more efficacious to manage thrombocytopaenia compared with platelet concentrates from random donors. Platelet genotyping and determination of HLA antibody specificity are needed to select compatible platelet units to expedite safe recovery from thrombocytopaenia in NAIT.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
emergency medicine, general surgery, mediacal education, resuscitation, surgery, trauma
in
BMJ Case Reports
volume
2017
publisher
BMJ Publishing Group
external identifiers
  • scopus:85021899170
ISSN
1757-790X
DOI
10.1136/bcr-2016-218269
language
English
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no
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23d957ab-b42d-4c31-bf90-ce333a8790c0
date added to LUP
2017-08-23 15:08:27
date last changed
2018-01-07 12:15:47
@article{23d957ab-b42d-4c31-bf90-ce333a8790c0,
  abstract     = {<p>Neonatal alloimmune thrombocytopaenia (NAIT) generally results from platelet opsonisation by maternal antibodies against fetal platelet antigens inherited from the infant's father. Newborn monochorionic twins presented with petechial haemorrhages at 10 hours of life, along with severe thrombocytopaenia. Despite the initial treatment with platelet transfusions and intravenous immunoglobulin, they both had persistent thrombocytopaenia during their first 45 days of life. Class I human leucocyte antigen (HLA) antibodies with broad specificity against several HLA-B antigens were detected in the maternal serum. Weak antibodies against HLA-B57 and HLA-B58 in sera from both twins supported NAIT as the most likely diagnosis. Platelet transfusion requirements of the twins lasted for 7 weeks. Transfusion of HLA-matched platelet concentrates was more efficacious to manage thrombocytopaenia compared with platelet concentrates from random donors. Platelet genotyping and determination of HLA antibody specificity are needed to select compatible platelet units to expedite safe recovery from thrombocytopaenia in NAIT.</p>},
  articleno    = {218269},
  author       = {Wendel, Kristina and Akkök, Çiǧdem Akalin and Kutzsche, Stefan},
  issn         = {1757-790X},
  keyword      = {emergency medicine,general surgery,mediacal education,resuscitation,surgery,trauma},
  language     = {eng},
  publisher    = {BMJ Publishing Group},
  series       = {BMJ Case Reports},
  title        = {Neonatal alloimmune thrombocytopaenia associated with maternal HLA antibodies},
  url          = {http://dx.doi.org/10.1136/bcr-2016-218269},
  volume       = {2017},
  year         = {2017},
}