Neonatal alloimmune thrombocytopenia caused by human leucocyte antigen-B27 antibody

Transfusion Medicine
H ThudeD Barz

Abstract

Neonatal alloimmune thrombocytopenia (NAIT) occurs when maternal alloantibodies to antigens presented on foetal platelets cause their immune destruction. Whether human leucocyte antigen (HLA) antibodies can cause NAIT is controversial. Here, a patient was described who suffered from a NAIT caused by an HLA-B27 antibody. Sera from the mother and the newborn were tested for human platelet antigen antibodies and HLA antibodies by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay, solid phase-linked immunosorbent assay (ELISA), lymphocytotoxicity assay (LCT) and flow cytometric analysis. No antibodies against cluster designation (CD)109 and platelet glycoproteins of the father were found in patient's and mother's serum. However, HLA ELISA was used to identify HLA antibody in both sera. The antibody was specified as HLA-B27 antibody. Typing results showed that the father descended HLA-B27 antigen on patient and his brother. The mother was HLA-B27 negative. It is most conceivable that the previous pregnancy of the mother induced the production of anti-HLA-B27 antibody, which crossed the placenta and subsequently caused an NAIT in the case presented.

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Citations

Oct 14, 2008·Transfusion Medicine Reviews·Donald M ArnoldJohn G Kelton
Dec 4, 2008·Advances in Pediatrics·Alice Chang HoftmanE Richard Stiehm
Sep 11, 2007·Seminars in Perinatology·YanYun Wu, Gary Stack
Feb 7, 2013·British Journal of Haematology·Julie A PetersonRichard H Aster
Jan 31, 2015·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Anna L HutchinsonLyn Downe
Apr 18, 2018·Transfusion·Jeremy Ryan PeñaBarbara O'Brien
Jun 11, 2016·Arteriosclerosis, Thrombosis, and Vascular Biology·Sentot SantosoUlrich J Sachs
Jan 20, 2010·Rheumatology·Nicholas J Sheehan
Nov 17, 2009·Acta Paediatrica·M StarcevicV Zah-Matakovic
Nov 16, 2011·The Journal of Immunology : Official Journal of the American Association of Immunologists·Gilles FoucrasFrançois Schelcher
Jul 2, 2020·Transfusion·Jesper DahlHeidi Tiller

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