Koyama N, Ohama Y, Kaneko K, Itakura Y, Nakamura T, Takasaki J, Tanaka T, Eguchi H, Kawase A, Kamiya K
Department of Pediatrics, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
Acta Paediatr Jpn. 1991 Feb;33(1):71-6. doi: 10.1111/j.1442-200x.1991.tb01522.x.
In order to evaluate the influence of maternal anti-HLA antibody on neonatal thrombocytopenia, clinical features and maternal anti-HLA antibody of three groups of infants (19 thrombocytopenic and low birth weight, 27 nonthrombocytopenic and low birth weight, and 80 healthy full-term) were investigated. The incidence of positive maternal anti-HLA antibodies in the three groups was 73.7%, 29.6% and 27.5%, respectively. Thrombocytopenia in small-for-gestational-age (SGA) infants was closely related to the presence of maternal anti-HLA antibodies. Among 20 SGA infants (11 thrombocytopenic, 9 non-thrombocytopenic), anti-HLA antibody was detected in 10 mothers (90.9%) of thrombocytopenic SGA infants, while it was positive in only one mother (11.1%) of nonthrombocytopenic SGA infants. Investigation of the SGA infants revealed that in those whose mothers were sensitized to HLA antigen, not only the platelet count but also the leukocyte and lymphocyte counts in the first week of life were significantly lower than in infants whose mothers were not sensitized. The results suggest that the presence of maternal anti-HLA antibody is a cause of neonatal thrombocytopenia especially in SGA infants.
为了评估母体抗人白细胞抗原（HLA）抗体对新生儿血小板减少症的影响，对三组婴儿（19例血小板减少且低体重、27例非血小板减少且低体重、80例健康足月儿）的临床特征及母体抗HLA抗体进行了调查。三组中母体抗HLA抗体阳性的发生率分别为73.7%、29.6%和27.5%。小于胎龄儿（SGA）的血小板减少症与母体抗HLA抗体的存在密切相关。在20例SGA婴儿（11例血小板减少，9例非血小板减少）中，血小板减少的SGA婴儿的10名母亲（90.9%）检测到抗HLA抗体，而非血小板减少的SGA婴儿只有1名母亲（11.1%）呈阳性。对SGA婴儿的调查显示，母亲对HLA抗原致敏的婴儿，不仅出生后第一周的血小板计数，而且白细胞和淋巴细胞计数均显著低于母亲未致敏的婴儿。结果表明，母体抗HLA抗体的存在是新生儿血小板减少症的一个原因，尤其是在SGA婴儿中。
