Department of Neonatology, University hospital Sestre milosrdnice, Zagreb, Croatia.
Acta Paediatr. 2010 Apr;99(4):630-2. doi: 10.1111/j.1651-2227.2009.01599.x. Epub 2009 Nov 13.
Neonatal alloimmune thrombocytopenia (NAIT) occurs as a result of maternal alloimmunization against paternally inherited antigens on foetal platelets. Platelets express platelet specific antigens (HPA) along with human leucocyte antigens (HLA) class I. Although anti-HLA class I antibodies are often detectable in pregnant women, their role in NAIT is considered controversial. We report a case of NAIT where the most sensitive serological analysis and molecular methods could not detect platelet specific antibodies. Only HLA incompatibility and presence of anti-HLA-A24 antibodies in both the mother's and the newborn's serum were proven.
This case supports the idea that some anti-HLA class I antibodies could cause NAIT.
新生儿同种免疫性血小板减少症(NAIT)是由于母体对胎儿血小板上的父系遗传抗原产生同种免疫引起的。血小板表达血小板特异性抗原(HPA)以及人类白细胞抗原(HLA)I 类。尽管抗 HLA I 类抗体在孕妇中经常可检测到,但它们在 NAIT 中的作用仍存在争议。我们报告了一例 NAIT 病例,最敏感的血清学分析和分子方法均未能检测到血小板特异性抗体。仅证实了母亲和新生儿血清中 HLA 不相容性和抗 HLA-A24 抗体的存在。
该病例支持某些抗 HLA I 类抗体可能导致 NAIT 的观点。