OJOG  Vol.4 No.5 , March 2014
Neonatal Alloimmune Thrombocytopenia Due to Maternal Anti HPA1a Antibodies: Case Report and Management of Subsequent Pregnancy
ABSTRACT

Fetoneonatal alloimmune thrombocytopenia is an infrequent and severe disease that is unexpectedly found after an uncomplicated first pregnancy. Affected infants might show unexplained purpura, intracranial hemorrhage, and/or gastrointestinal or genitourinary hemorrhage. Nevertheless, in asymptomatic newborns the thrombocytopenia may be discovered incidentally. We describe a case report that highlights that the incidental diagnosis of FNAIT allows both properly managing the newborn, and detecting maternal anti-HPA1a antibodies in order to prevent the disease in subsequent pregnancies. A non-invasive treatment based on IVIgG allowed to this patient to prevent FNAIT in her second pregnancy.


Cite this paper
Cruz, V. , Martínez-Varea, A. , Núñez-Valera, M. , Abad-Carrascosa, A. , Diago, V. and Perales-Marín, A. (2014) Neonatal Alloimmune Thrombocytopenia Due to Maternal Anti HPA1a Antibodies: Case Report and Management of Subsequent Pregnancy. Open Journal of Obstetrics and Gynecology, 4, 213-216. doi: 10.4236/ojog.2014.45035.
References
[1]   Fratellanza, G., Fratellanza, A., Paesano, L., Scarcella, A., Safoian, A., Misso, S., Formisano, S. and Scarpato, N. (2006) Fetoneonatal Alloimmune Thrombocytopenia (FNAIT): Our Experience. Transfusion and Apheresis Science, 35, 111-117. http://dx.doi.org/10.1016/j.transci.2006.07.005

[2]   van den Akker, E.S. and Oepkes, D. (2008) Fetal and Neonatal Alloimmune Thrombocytopenia. Best Practice & Research Clinical Obstetrics & Gynaecology, 22, 3-14. http://dx.doi.org/10.1016/j. bpobgyn.2007.08.001

[3]   Kuijpers, R.W., van den Anker, J.N., Baerts, W. and von dem Borne, A.E. (1994) A Case of Severe Neonatal Thrombocytopenia with Schizencephaly Associated with Anti-HPA-1b and Anti-HPA-2a. British Journal of Haematology, 87, 576-579. http://dx.doi.org/10.1111/j.1365-2141.1994.tb08315.x

[4]   Constantinescu, S., Zamfirescu, V., Vladareanu, R. (2012) Fetal and Neonatal Alloimmune Thrombocytopenia. Maedica, 7, 372-376.

[5]   Jeremiah, Z.A., Atiegoba, A.I. and Mgbere, O. (2011) Alloantibodies to Human Platelet Glycoprotein Antigens (HPA) and HLA Class 1 in a Cross Section of Nigerian Antenatal Women. Human Antibodies, 20, 71-75.

[6]   Winters, J.L., Jennings, C.D., Desai, N.S., Dickson, L.G. and Ford, R.F. (1998) Neonatal Alloimmune Thrombocytopenia Due to Anti-HPA-1b (PLA2)(Zwb). A Case Report and Review. Vox Sanguinis, 74, 256-259. http://dx.doi.org/10.1046/j.1423-0410.1998.7440256.x

[7]   Ghevaert, C., Herbert, N., Hawkins, L., Grehan, N., Cookson, P., Garner, S.F., Crisp-Hihn, A., Lloyd-Evans, P., Evans, A., Balan, K., Ouwehand, W.H., Armour, K.L., Clark, M.R. and Williamson, L.M. (2013) Recombinant HPA-1a Antibody Therapy for Treatment of Fetomaternal Alloimmune Thrombocytopenia: Proof of Principle in Human Volunteers. Blood, 122, 313-320.
http://dx.doi.org/10.1182/blood-2013-02-481887

 
 
Top