Neonatal thrombocytopenia induced by maternal anti-HLA antibodies: a potential side effect of allogenic leukocyte immunization for unexplained recurrent aborters

Tanaka, Tetsuji; Umesaki, Naohiko; Nishio, Junko; Maeda, Kento; Kawamura, Tomoyuki; Araki, Nobuhito; Ogita, Sachio

doi:10.1016/s0165-0378(99)00050-9

Cited by 31 publications

(17 citation statements)

References 15 publications

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“…In humans, MHC class I alloantibodies in individual cases of fetal/neonatal alloimmune thrombocytopenia (FNAIT) have been reported a number of times during the past decades (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). In addition to thrombocytopenia, the presence of an associated neutropenia is noticed in a few cases (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

Foucras

Corbière

Tasca

et al. 2011

The Journal of Immunology

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Fetal/neonatal alloimmune thrombocytopenia is a frequent disease in humans where alloantibodies against platelet Ags lead to platelet destruction and hemorrhage. Although a role in the disease for Abs against MHC has been suspected, this has not been formally demonstrated. Since 2007, a hemorrhagic syndrome due to thrombocytopenia and designated as bovine neonatal pancytopenia (BNP) has been recognized in calves in several European countries. An inactivated antiviral vaccine is strongly suspected to be involved in this syndrome because of its highly frequent use in the dams of affected calves. In this study, we show that BNP is an alloimmune disease, as we reproduced the signs by transferring serum Abs from vaccinated BNP dams into healthy neonatal calves. Ab specificity was strongly associated with the presence of allogeneic MHC class I Abs in the dams. MHC class I staining was also observed on Madin–Darby bovine kidney cells, a cell line related to the one used to produce the vaccine Ag. Our report emphatically demonstrates that alloimmunization against MHC class I is associated with a substantial risk of developing cytopenia-associated syndromes in neonates when a cell line of the same species is used to produce an inactivated vaccine injected into the mother.

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Section: Discussionmentioning

confidence: 99%

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

Foucras

Corbière

Tasca

et al. 2011

The Journal of Immunology

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“…The cross-match tests between the maternal serum and the baby’s leukocytes or platelets were strongly positive. Tanaka et al [8]reported the case of a female baby with an asymptomatic thrombocytopenia 4 days after delivery whose mother’s serum contained HLA antibodies. The father’s and the baby’s platelets reacted with these antibodies.…”

Section: Discussionmentioning

confidence: 99%

“…In the field of neonatal alloimmune thrombocytopenia (NAIT), the anti-HPA-1a represents the most common specificity at the origin of the disease [4, 5]. However in some NAIT cases in whom no platelet-specific antibodies are found, HLA antibodies are suspected of being involved [6, 7, 8]. Actually, it is a rare event among frequently HLA alloimmunized pregnant women [9], and it is to be noted that the role of these antibodies remains unclear [10].…”

Section: Introductionmentioning

confidence: 99%

HLA Antibodies and Neonatal Alloimmune Thrombocytopenia

Moncharmont¹,

Dubois²,

Obegi³

et al. 2004

Acta Haematol

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A female baby with a severe thrombocytopenia at 18 × 10⁹/l was born to a 29-year-old (gestation 2/partum 2) mother. Scattered petechiae were present on her legs, arms, chest and face, but there was no bleeding, infection, fever or hepatosplenomegaly. A platelet antibody screening immunocapture test was positive, which was performed on the mother’s serum 3, 12 and 38 days after delivery, but no platelet-specific antibodies were found by the monoclonal-antibody-specific immobilization of platelet antigen assay. The baby’s platelets and lymphocytes and the father’s platelets reacted strongly with the HLA antibodies present in the mother’s serum. The neonate was treated with intravenous human immunoglobulin (Tegeline^®, 1 g/kg per day) 1, 2 and 3 days after delivery. The platelet count rose from 18 × 10⁹/l on day 0 to 37 × 10⁹/l on day 3 and to 227 × 10⁹/l on day 12. No platelet transfusion was needed. Several factors which developed hereafter lead us to think that this neonatal alloimmune thrombocytopenia is due to the transplacental passage of maternal HLA antibodies to the baby.

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“…Treatment with paternal leukocytes immunization, as previously suggested [20], is no longer recommended because of the possible side effects to the mother and the fetus due to an unpredicted immune response to either autologic or allogenic blood components [19,73,103]. On the other hand, high dose IVIg administration carries less risk and was found to benefit patients with RIF who share HLA alleles with their partner [34].…”

Section: Immunological Factorsmentioning

confidence: 99%

Assessment and treatment of repeated implantation failure (RIF)

Simon

Laufer

2012

J Assist Reprod Genet

209

161

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Repeated implantation failure (RIF) is determined when embryos of good quality fail to implant following several in vitro fertilization (IVF) treatment cycles. Implantation failure is related to either maternal factors or embryonic causes. Maternal factors include uterine anatomic abnormalities, thrombophilia, non-receptive endometrium and immunological factors. Failure of implantation due to embryonic causes is associated with either genetic abnormalities or other factors intrinsic to the embryo that impair its ability to develop in utero, to hatch and to implant. New methods of time-lapse imaging of embryos and assessment of their metabolic functions may improve selection of embryos for transfer, and subsequent outcomes for IVF patients, as well as for those diagnosed with RIF. This review discusses the various causes associated with RIF and addresses appropriate treatments.

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Neonatal thrombocytopenia induced by maternal anti-HLA antibodies: a potential side effect of allogenic leukocyte immunization for unexplained recurrent aborters

Cited by 31 publications

References 15 publications

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

HLA Antibodies and Neonatal Alloimmune Thrombocytopenia

Assessment and treatment of repeated implantation failure (RIF)

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