Pereira J, Pizarro I, Winter A, Mezzano D
Departamento de Hematología y Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago.
Rev Med Chil. 1992 Aug;120(8):899-904.
Maternal alloimmunization against fetal platelets can cause fetal and neonatal thrombocytopenia. We report our experience in the study of five cases with severe neonatal-thrombocytopenia. Using an ELISA with antigen capture and other serologic tests on platelets, we investigated the sera of the five mothers. Sera from four mothers contained a platelet-specific alloantibody, anti-HPA-1a (PlA1) whereas the platelets typed as HPA-1b/b. In one case despite extensive serological investigation and clinically unequivocal diagnosis of AINT, no antibodies were demonstrated. The use of monoclonal antibodies for antigen immobilization, showed to be a reliable and sensitive test for the detection and identification of platelet antibodies in AINT. These techniques could also be used in the follow-up of patients at risk (e.g. pregnant HPA-1b/b women) and in the screening of blood donors lacking of certain antigens, whose platelets are collected to be transfused in patients with platelet-specific antibodies.
母体对胎儿血小板的同种免疫可导致胎儿和新生儿血小板减少症。我们报告了对5例严重新生儿血小板减少症的研究经验。通过使用抗原捕获ELISA和其他血小板血清学检测方法,我们对5位母亲的血清进行了检测。4位母亲的血清中含有血小板特异性同种抗体抗-HPA-1a(PlA1),而其血小板类型为HPA-1b/b。在1例病例中,尽管进行了广泛的血清学调查且临床诊断明确为同种免疫性新生儿血小板减少症(AINT),但未检测到抗体。使用单克隆抗体进行抗原固定,结果表明这是一种用于检测和鉴定AINT中血小板抗体的可靠且灵敏的检测方法。这些技术还可用于有风险患者(如HPA-1b/b型孕妇)的随访以及缺乏某些抗原的献血者筛查,这些献血者的血小板被采集用于输注给有血小板特异性抗体的患者。