Persistent neonatal alloimmune thrombocytopenia caused by triple anti-HLA-A11, -B3901, and -Cw7 antibodies.

IF 1.7 4区医学 Q3 HEMATOLOGY

International Journal of Hematology Pub Date : 2025-03-31 DOI:10.1007/s12185-025-03968-4

Shiho Hatano, Hajime Maeda, Hirotaka Ichikawa, Kei Ogasawara, Nozomi Takano, Shunya Rikimaru, Kinuyo Kawabata, Kazuhiko Ikeda, Hitoshi Ohto, Hayato Go

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引用次数: 0

Abstract

Background: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is primarily caused by the transplacental passage of maternal antibodies commonly directed against fetal human platelet antigens (HPA) and rarely against human leukocyte antigens (HLA).

Study design and methods: Here, we report a case of prolonged neonatal alloimmune thrombocytopenia (NAIT) associated with three anti-HLA antibodies. A male infant was delivered at 37 weeks' gestation because of non-reassuring fetal status. His platelet count decreased to 14 × 10⁹/L on postnatal day 8. A random-donor platelet transfusion and intravenous immunoglobulin were administered without clinical complications. Immunoserological investigations were performed to identify HLA, HPA, and antibodies in the patient and his parents.

Results: Anti-HLA-A11, -B3901, and -Cw7 antibodies, but not anti-HPA antibodies, were identified in the mother's blood that reacted with the lymphocytes of the infant and his father.

Conclusion: Three distinct anti-HLA (HLA-A11, B3901, and Cw7) may have caused the prolonged neonatal thrombocytopenia observed in the present case. This case report demonstrates the role of anti-HLA antibodies in the pathogenesis of FNAIT.

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由hla - a11、-B3901和-Cw7三重抗体引起的持久性新生儿同种免疫血小板减少症。

背景：胎儿和新生儿同种免疫性血小板减少症（FNAIT）主要是由母体抗体经胎盘传递引起的，通常针对胎儿人血小板抗原（HPA），很少针对人白细胞抗原（HLA）。研究设计和方法：在这里，我们报告一例新生儿同种免疫性血小板减少症（NAIT）与三种抗hla抗体相关。一个男婴在妊娠37周分娩，因为胎儿状态不稳定。出生后第8天血小板计数降至14 × 109/L。随机供体血小板输注和静脉注射免疫球蛋白无临床并发症。通过免疫血清学检查确定患者及其父母的HLA、HPA和抗体。结果：在母亲血液中检测到抗hla - a11、-B3901和-Cw7抗体，但未检测到抗hpa抗体，这些抗体可与婴儿及其父亲的淋巴细胞发生反应。结论：三种不同的hla抗体（HLA-A11、B3901和Cw7）可能导致本例新生儿血小板减少症的延长。本病例报告证明了抗hla抗体在FNAIT发病机制中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Hematology 医学-血液学

CiteScore

3.90

自引率

4.80%

发文量

223

审稿时长

6 months

期刊介绍： The International Journal of Hematology, the official journal of the Japanese Society of Hematology, has a long history of publishing leading research in hematology. The journal comprises articles that contribute to progress in research not only in basic hematology but also in clinical hematology, aiming to cover all aspects of this field, namely, erythrocytes, leukocytes and hematopoiesis, hemostasis, thrombosis and vascular biology, hematological malignancies, transplantation, and cell therapy. The expanded [Progress in Hematology] section integrates such relevant fields as the cell biology of stem cells and cancer cells, and clinical research in inflammation, cancer, and thrombosis. Reports on results of clinical trials are also included, thus contributing to the aim of fostering communication among researchers in the growing field of modern hematology. The journal provides the best of up-to-date information on modern hematology, presenting readers with high-impact, original work focusing on pivotal issues.