Moncharmont P, Vignal M, Merieux Y, Rigal D
Etablissement français du sang, Rhône-Alpes, site de Lyon-Gerland, 1-3, rue du Vercors, 69364 Lyon cedex 07, France.
Arch Pediatr. 2007 Sep;14(9):1094-6. doi: 10.1016/j.arcped.2007.05.008. Epub 2007 Jun 21.
Fetal and neonatal alloimmune thrombocytopenia due to mothers' anti-HPA-5b alloimmunization has generally a milder clinical presentation compared to anti-HPA-1a alloimmunization. Nevertheless, a case with infant's death probably due to intracranial haemorrhage has been reported. However, if platelet-specific alloimmunized mothers with prior fetal or neonate injury receive intravenous immunoglobulins during pregnancy, thrombocytopenia in heterozygous fetus and neonate may be prevented. Here are reported 2 cases of anti-HPA-5b fetal-maternal alloimmunization, one with prior fetal death, the other with prior severe fetal intracranial haemorrhage, which were successfully treated with intraveinous immunoglobulins alone during a second pregnancy with HPA-5b incompatibility.
与母亲抗HPA-1a同种免疫相比,母亲抗HPA-5b同种免疫所致的胎儿及新生儿同种免疫性血小板减少症通常临床表现较轻。然而,曾有报道1例婴儿可能因颅内出血死亡。不过,如果既往有胎儿或新生儿损伤的血小板特异性同种免疫母亲在孕期接受静脉注射免疫球蛋白,杂合子胎儿及新生儿的血小板减少症可能得以预防。本文报道2例抗HPA-5b胎儿-母体同种免疫病例,1例既往有胎儿死亡,另1例既往有严重胎儿颅内出血,在HPA-5b不相容的第二次妊娠期间单独使用静脉注射免疫球蛋白成功治疗。