Neonatal allo-immune thrombocytopenia due to fetomaternal HPA-1 incompatibility of a homozygous HPA-1a mother and a homozygous HPA-1b father

Moser, Russell J.; Faé, Ingrid; Neumeister, Alexander; Pober, Michael; Mutz, I; Panzer, Simon

doi:10.1007/bf01959215

Cited by 7 publications

(15 citation statements)

References 10 publications

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“…Based on gene frequencies analysis, NAIT due to anti-HPA-lb would be expected to occur more frequently than due to anti-HPA-la. Clinically, however, NAIT due to anti-HPA-lb immunization is very rare (Moser et al, 1994). It has been suggested that the l e~c i n e~~ -proline3' substitution binds weakly to HLA class I1 molecules to induce allorecognition (Kuijpers et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

Maternal alloimmunization against fetal platelet antigens: a prospective study

et al. 1995

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Neonatal alloimmune thrombocytopenia (NAIT) is induced by maternal alloantibodies to fetal platelet antigens. This prospective study was carried out to evaluate the incidence of anti-platelet antibodies in 933 mother-child pairs where the mother and child were typed for the human platelet antigens (HPA)-1, -2, -3, -5. Sera from mismatched mother-child pairs were screened for anti-platelet antibodies, anti-HLA class I and blood group ABO IgG antibodies. Platelet-specific antibodies were anti-HPA-3a in one and anti-HPA-5b in 17 neonates, respectively. All these neonates had normal platelet counts. One woman had autoreactive antibodies. Anti-HLA class I and anti-blood group A IgG antibodies were detected in five and four neonates, respectively, born with a platelet count < 150 x 10(9)/l. None of the 11 homozygous HPA-1b mothers became immunized against their heterozygous offspring. The maternal HLA-allotypes HLA-DR52 and -DR6, typically found in individuals immunized against HPA-1a and -5b, respectively, were found in three of 11 HPA-b/b nonresponders and eight of the anti-HPA-5b responders. The results indicate that a risk for NAIT due to HPA-2 and -3 alloimmunization is low. The HLA allotypes do not predict the risk for NAIT due to HPA-1 or -5 alloimmunization. Maternal anti-HPA-5b antibodies do not correlate with the platelet count in the neonate.

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Section: Discussionmentioning

confidence: 99%

Maternal alloimmunization against fetal platelet antigens: a prospective study

et al. 1995

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“…7,[20][21][22][23][24]27 Three cases reported the first symptoms during the second day of life. 25,25,26 Nadir platelet count was usually noted in the second day of life. 7,22,23,25,26 Skin bleeding (face, back and chest petechiae and purpura) was the most commonly observed type of bleeding in affected infants.…”

Section: Discussionmentioning

confidence: 99%

“…25,25,26 Nadir platelet count was usually noted in the second day of life. 7,22,23,25,26 Skin bleeding (face, back and chest petechiae and purpura) was the most commonly observed type of bleeding in affected infants. In this case, skin bleeding was not detected, but the infant presented with signs of ICH immediately after delivery.…”

Section: Discussionmentioning

confidence: 99%

Severe intracranial haemorrhage in neonatal alloimmune thrombocytopenia due to antibodies against human platelet antigen 1b: Case report and literature review

Tomac

Gojčeta

Grizelj

et al. 2022

Transfusion Medicine

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Fetal/neonatal alloimmune thrombocytopenia (FNAIT) is a rare life-threatening disorder, leading to severe thrombocytopenia and potentially bleeding, with intracranial haemorrhage (ICH) being the most serious complication. We report on a FNAIT case with fourth-degree ICH that arose due to antibodies against human platelet antigen (HPA)-1b. The male infant, born to an otherwise healthy mother, presented with severe signs of ICH soon after delivery. Since only moderate thrombocytopenia was noted and there were no active signs of bleeding, the infant did not receive intravenous immunoglobulins (IVIg) or platelet transfusion. Spontaneous recovery of platelets was noted on the eighth day of life, but permanent neurological impairment remained as a consequence of ICH. We report the results of HPA and human leukocyte antigen (HLA) antibodies in the mother's and the infant's sera, the family's HPA genotype and the mother's HLA genotype, and summarise previously described cases of FNAIT due to anti-HPA-1b antibodies in the literature. FNAIT with severe ICH due to anti-HPA-1b antibodies is rarely diagnosed. An association between HLA genes and sensitization to HPA-1b antibodies was not demonstrated. The severity of FNAIT and the occurrence of ICH is often difficult to predict. In this case, the infant presented with moderate thrombocytopenia and ICH, with subsequent permanent consequences.

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“…However, all samples from subjects who had formed anti-HPA-la antibodies were found to be regular HPA-lbib. Moreover, a common paternal HPA-lb and not HPA-lb,,, gave rise to the immunization of the HPA-la/a mother who delivered a child with neonatal alloimmune thrombocytopenia [8].…”

Section: Discussionmentioning

confidence: 99%

“…Glycoprotein llla (data not shown). The immunogenicity of HPA-lb,,, could not be evaluated as a homozygous HPA-lb individual, who fathered a child with neonatal alloimmune thrombocytopenia due to anti-HPA-lb antibodies, was of the common HPA-lb/b type [8]. We next evaluated whether HPA-lb,,, predisposes to anti-HPA-la immunization.…”

Section: Hpa-1 B/b Hpa-1 B/bvarmentioning

confidence: 99%

A Rare Leucine^40/Arginine^40 Polymorphism on Platelet Glycoprotein lila Is Linked to the Human Platelet Antigen 1b

Walchshofer¹,

Ghali²,

Fink³

et al. 1994

Vox Sanguinis

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A rare polymorphism on glycoprotein (GP) Ilia is reported. Sequencing of a 482- base-pair (bp) PCR product of the genomic DNA of GPIIIa revealed a singlebase exchange of a G↔T polymorphism at base 12,569 that created an additional restriction site for Mspl. This single-point mutation (frequency in Caucasians 0.00386) is on the HPA-lb gene (HPA-lb^(var)) and codominantly inherited. The exchange of a G for a T results in a leucine-to-arginine substitution at amino acid 40 from the NH(2) terminus. The binding of anti-HPA-la and -lb antibodies to HPA-lb(var) platelets is not influenced.

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Neonatal allo-immune thrombocytopenia due to fetomaternal HPA-1 incompatibility of a homozygous HPA-1a mother and a homozygous HPA-1b father

Cited by 7 publications

References 10 publications

Maternal alloimmunization against fetal platelet antigens: a prospective study

Maternal alloimmunization against fetal platelet antigens: a prospective study

Severe intracranial haemorrhage in neonatal alloimmune thrombocytopenia due to antibodies against human platelet antigen 1b: Case report and literature review

A Rare Leucine^40/Arginine^40 Polymorphism on Platelet Glycoprotein lila Is Linked to the Human Platelet Antigen 1b

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