Severe HPA-15b related neonatal alloimmune thrombocytopenia

• Published in: Acta Paediatrica Vol. 96; no. 11; pp. 1701 - 1703
• Main Authors: Moncharmont, P, Courvoisier, S, Pagnier, A, Cotta, L, Debillon, T, Rigal, D
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-11-2007; Blackwell
• Subjects: Adult; Alloimmunization; Antigens, CD - blood; Antigens, CD - immunology; Antigens, Human Platelet - blood; Antigens, Human Platelet - immunology; Biological and medical sciences; Blood Group Incompatibility - complications; Blood Group Incompatibility - diagnosis; Blood Group Incompatibility - therapy; Cesarean Section; Female; General aspects; GPI-Linked Proteins; Hematologic and hematopoietic diseases; HPA-15b; Humans; Infant, Newborn; Male; Maternal-Fetal Exchange - immunology; Medical sciences; Neonate; Neoplasm Proteins - blood; Neoplasm Proteins - immunology; Platelet diseases and coagulopathies; Platelet Transfusion; Pregnancy; Pregnancy Complications, Hematologic - immunology; Purpura, Thrombocytopenic - etiology; Thrombocytopenia; Thrombocytopenia, Neonatal Alloimmune - diagnosis; Thrombocytopenia, Neonatal Alloimmune - immunology; Thrombocytopenia, Neonatal Alloimmune - therapy; Human; Thrombocytopenia; Pediatrics; Neonatal; HPA-15b; Hemopathy; Allogeneic system; Isoimmunization; Platelet; Throm bocytopenia; Newborn; Neonate; Severe; Alloimmunization
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2007.00483.x

The HPA‐15 platelet (PLT) group was recently described. Severe neonatal thrombocytopenia due to alloimmunization by HPA‐15b has very rarely been observed. A 22‐year‐old mother, gravida 1/para 1, gave birth to a male infant who presented with a severe thrombocytopenia, the PLT count recorded to be 3 ×109/L. A few hours after birth, he developed purpura with extensive haematomas but without visceral or intracranial haemorrhage (ICH). Two PLT transfusions were given including one using maternal PLTs. The infant's PLT count was 267 × 109/L on day 6. The maternal platelet group was HPA‐15a/a and her infant was HPA‐15a/b. Anti‐HPA‐15b antibodies was found in maternal serum.
Conclusion: HPA‐15b maternal alloimmunization may induce severe neonatal thrombocytopenia. In order to establish the frequency of neonatal alloimmune thrombocytopenia (NAIT) due to anti‐HPA‐15b antibodies, an improved detection method is necessary.