Abstract
Fetoneonatal alloimmune thrombocytopenia is an infrequent and severe disease that is unexpectedly found after an uncomplicated first pregnancy. Affected infants might show unexplained purpura, intracranial hemorrhage, and/or gastrointestinal or genitourinary hemorrhage. Nevertheless, in asymptomatic newborns the thrombocytopenia may be discovered incidentally. We describe a case report that highlights that the incidental diagnosis of FNAIT allows both properly managing the newborn, and detecting maternal anti-HPA1a antibodies in order to prevent the disease in subsequent pregnancies. A non-invasive treatment based on IVIgG allowed to this patient to prevent FNAIT in her second pregnancy.
Highlights
Fetoneonatal alloimmune thrombocytopenia (FNAIT) is a rare but severe condition that arises from maternal alloimmunization against a fetal platelet antigen inherited from the father and absent on maternal platelets [1]
A large number of fetal platelets in maternal circulation can trigger the maternal production of alloantibodies, firstly immunoglobulin (Ig) M and later IgG, which can cross the placenta
We describe a case in which a woman developed anti human platelet antigens (HPA) 1a antibodies during her first pregnancy, which originated FNAIT
Summary
Fetoneonatal alloimmune thrombocytopenia (FNAIT) is a rare but severe condition that arises from maternal alloimmunization against a fetal platelet antigen inherited from the father and absent on maternal platelets [1]. How to cite this paper: Serrano-dela Cruz, V., et al (2014) Neonatal Alloimmune Thrombocytopenia Due to Maternal Anti HPA1a Antibodies: Case Report and Management of Subsequent Pregnancy. Neonatal thrombocytopenia is unexpectedly found in first pregnancy [3]. During this first pregnancy, fetal platelets can reach maternal circulation. In the same or in following pregnancies with the same partner, these maternal antibodies of IgG class may reach the fetal blood and mediate the immune destruction of the fetal platelets, leading to fetal and neonatal thrombocytopenia [1]. We describe a case in which a woman developed anti HPA 1a antibodies during her first pregnancy, which originated FNAIT. A close follow-up coupled with intravenous immunoglobulin G was essential to prevent alloimmune thrombocytopenia in her second child
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