Neonatal alloimmune thrombocytopaenia associated with maternal HLA antibodies

Wendel, Kristina; Akkök, Çiğdem Akalın; Kutzsche, Stefan

doi:10.1136/bcr-2016-218269

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…A major limitation of these studies, involving unselected pregnant women, was the very low number or even absence of thrombocytopenic newborns. Despite the negative findings observed in unselected pregnant women, numerous case reports have been published in which neonatal thrombocytopenia, occasionally accompanied by severe bleeding complications, occurred in women with anti‐HLA class I antibodies (Svejgaard et al , ; Sternbach et al , ; Evans, ; Chow et al , ; Onishi et al , ; del Rosario et al , ; Sasaki et al , ; Tanaka et al , ; Saito et al , ; Moncharmont et al , ; Thude et al , ; Gramatges et al , ; Starcevic et al , ; Hutchinson et al , ; Nakamura et al , ; Meler et al , ; Wendel et al , ). The authors suggested a causal relationship between maternal anti‐HLA antibodies and foetal or neonatal disease.…”

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confidence: 99%

Maternal antibodies against paternal class I human leukocyte antigens are not associated with foetal and neonatal alloimmune thrombocytopenia

et al. 2020

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The causative role of maternal, anti-human leukocyte antigen (anti-HLA) class I antibodies in foetal and neonatal alloimmune thrombocytopenia (FNAIT) remains controversial. Furthermore, in FNAIT cases caused by anti-human platelet antigen-1a (anti-HPA-1a) antibodies, the possible additive effect of maternal anti-HLA class I antibodies on outcomes is unclear. Among 817 mother-father-neonate trios of suspected FNAIT, we assessed the possible association of maternal anti-HLA class I antibodies with neonatal platelet count, and the incidence of FNAIT caused by anti-HPA-1a antibodies. In 144 FNAIT cases caused by anti-HPA-1a antibodies, we investigated the possible association of maternal anti-HLA class I antibodies with neonatal platelet count, birth weight, and the incidence of intracranial haemorrhage (n = 16). Maternal anti-HLA class I antibodies were not associated with neonatal platelet count in suspected cases of FNAIT. There was no significant interaction between the presence of anti-HLA class I antibodies and anti-HPA-1a antibodies. In FNAIT cases caused by anti-HPA-1a antibodies, there was no association between the presence of anti-HLA class I antibodies and neonatal platelet count, birth weight, or occurrence of intracranial haemorrhage. This study's findings do not support the concept that maternal anti-HLA class I antibodies represent a risk factor of FNAIT or disease severity.

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confidence: 99%

Maternal antibodies against paternal class I human leukocyte antigens are not associated with foetal and neonatal alloimmune thrombocytopenia

et al. 2020

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“…NAIT is caused by maternal immunoglobulin G alloantibodies that cross the placenta and are directed against HPAs on fetal platelets [ 7 ]. While the HPA antigens frequently involve maternal alloantibodies against HPA, human leucocyte antigen (HLA) antibody binding to platelets is a rare cause of NAIT [ 8 ]. In the fetal blood, the alloantibodies attack the platelet surfaces, as mentioned above, and neonatal thrombocytopenia ensues [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Neonatal Alloimmune Thrombocytopenia Following Maternal Pemphigoid Gestationis

Chism,

Fives,

Beetz

et al. 2023

Cureus

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Neonatal alloimmune thrombocytopenia (NAIT) is a complex condition, stemming from the transplacental passage of alloantibodies from a pregnant mother directed against fetal platelet antigens. This case report discusses a rare instance of severe NAIT initially presenting as inadequate weight gain. After a clinical workup yielded negative findings for an infection and the resolution of the patient's thrombocytopenia following the administration of platelet products and intravenous immunoglobulin (IVIG), hematology deduced that this patient’s NAIT was secondary to maternal history of gestational pemphigus. We describe the pathophysiology and current understanding of NAIT, pemphigoid gestationis (PG), as well as an analysis of their association. This intersection of NAIT and maternal PG underscores the importance of considering potential interactions between maternal autoimmune conditions overall and their impact on fetal health.

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“…However, several reports about anti-HLA antibody binding to platelets and cause FNAIT have also been published [57,58]. Studies concluded that the presence of anti-HLA class I antibodies should be considered as a potential cause of NAIT, especially in cases with a very high titter of antibodies.…”

Section: Foetal/neonatal Alloimmune Thrombocytopaeniamentioning

confidence: 99%

Human Leucocyte Antigens in blood transfusion

Grubić

2019

ISBT Science Series

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Human Leucocyte Antigen (HLA) genes and molecules have an important role in transplantation, aetiology of many autoimmune, non-autoimmune and infection diseases. Due to the extremely high polymorphism of HLA genes and their different frequency distributions in various populations, an increasing probability of HLA non-compatible blood products, tissues or organs usage exists. For that reason, the aim of this paper was to give a concise overview of the role of HLA antigens and antibodies in adverse reactions caused by administration of transfusion products. The HLA system can cause detrimental immune reactions in transfusion therapy (platelet immune refractoriness, febrile transfusion reaction, transfusion-related acute lung injury and transfusion-associated graft versus host disease). Anti-HLA antibodies present in the patient are responsible for some of these reactions, while anti-HLA antibodies or HLA reactive cells present in the transfused product are accountable for immune-reactivity in other cases. In order to avoid or reduce the development of these transfusion-related events, anti-HLA antibody-negative or compatible products should be used. This is increasingly facilitated by introduction of more sensitive and specific techniques to determine anti-HLA antibodies and gene polymorphisms. In conclusion, the most common adverse reactions related to administration of incompatible HLA transfusion products are discussed. Basic information about HLA genes and antibodies as well as methods for their detection is also provided in order to give sufficient data for safe and efficient administration of transfusion products.

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Neonatal alloimmune thrombocytopaenia associated with maternal HLA antibodies

Cited by 7 publications

References 8 publications

Maternal antibodies against paternal class I human leukocyte antigens are not associated with foetal and neonatal alloimmune thrombocytopenia

Maternal antibodies against paternal class I human leukocyte antigens are not associated with foetal and neonatal alloimmune thrombocytopenia

A Case of Neonatal Alloimmune Thrombocytopenia Following Maternal Pemphigoid Gestationis

Human Leucocyte Antigens in blood transfusion

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