Neonatal neutropenia and bacterial sepsis associated with placental transfer of maternal neutrophil-specific autoantibodies

Transfusion
Anne DavorenBrian R Curtis

Abstract

Passively acquired neonatal neutropenia is an infrequently reported complication of maternal autoimmune neutropenia (AIN). Two affected siblings are described. The firstborn developed Citrobacter meningitis and was permanently disabled. The second was success-fully managed with pre- and postnatal injections of recombinant human granulocyte colony-stimulating factor (rHuG-CSF). Neutrophil-specific antibodies were evaluated by flow cytometry (FC), monoclonal antibody immobilization of granulocyte antigens, and granulocyte agglutination assays. A neutrophil-reactive antibody was detected by FC in samples of the mother's serum spanning a 4-year time frame. This antibody reacted with neutrophils from the mother, father, and their first infant and with 18 of 20 target neutrophils tested. In serologic studies, it was shown that the antibody was not specific for the commonly recognized neutrophil-specific alloantigens HNA-1a (NA1), HNA-1b (NA2), HNA-1c (SH), HNA-2a (NB1), or HNA-3a (5b). Severe neonatal neutropenia in the two siblings appears to have been caused by placental transfer of a maternal neutrophil-reactive autoantibody of undetermined specificity. Neutrophil counts should be evaluated in infants born to mothers with chronic ...Continue Reading

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Citations

Apr 3, 2010·International Journal of Hematology·Ahmad M WehbeThorvardur R Halfdanarson
Apr 18, 2006·Critical Care Medicine·Brian R Curtis, Janice G McFarland
Feb 16, 2010·American Journal of Clinical Pathology·David R CzuchlewskiKathryn Foucar
Dec 4, 2008·Advances in Pediatrics·Alice Chang HoftmanE Richard Stiehm
Sep 14, 2007·Acta Paediatrica·P MoncharmontD Rigal
May 1, 2007·Transfusion·Cedric GhevaertEdmund Ranasinghe
Apr 11, 2008·Transfusion Medicine·C D De La Vega ElenaE Muñiz-Díaz
Aug 17, 2006·American Journal of Reproductive Immunology : AJRI·Christiane KlingDieter Kabelitz
Oct 28, 2010·Transfusion·Jerome L GottschallUNKNOWN NHLBI Retrovirus Epidemiology Donor Study II
Nov 20, 2015·World Journal of Pediatrics : WJP·Piero Farruggia
Feb 3, 2015·Therapeutic Advances in Hematology·Piero Farruggia, Carlo Dufour
Mar 23, 2019·Journal of Clinical Immunology·Julie SeguierNicolas Schleinitz

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