Mueller-Eckhardt C, Kiefel V, Grubert A, Kroll H, Weisheit M, Schmidt S, Mueller-Eckhardt G, Santoso S
Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Federal Republic of Germany.
Lancet. 1989 Feb 18;1(8634):363-6. doi: 10.1016/s0140-6736(89)91733-9.
Serological and clinical data were collected in 348 cases of suspected neonatal alloimmune thrombocytopenia (NAT). Of the 144 mothers who were Zwa-negative, 107 had Zwa antibodies--alone (94); with HLA antibodies (12); or with Bra antibodies (1). Antibodies were detected in 12 of the 204 Zwa-positive mothers as follows: anti-Bra (9), anti-Zwb (1), anti-Baka with HLA antibody (1), and blood group B isoagglutinins (1). The frequency of NAT due to Bra incompatibility (19%) was second to Zwa (78%). Zwa-NAT was clinically the more severe (14% had intracranial haemorrhages) and responded well to either maternal platelet transfusions or intravenous IgG. In Bra-NAT intracranial haemorrhages were not observed and most children recovered without specific therapy.
收集了348例疑似新生儿同种免疫性血小板减少症(NAT)患者的血清学和临床数据。在144例Zwa阴性的母亲中,107例有Zwa抗体——单独存在(94例);伴有HLA抗体(12例);或伴有Bra抗体(1例)。在204例Zwa阳性的母亲中,12例检测到抗体,情况如下:抗Bra(9例)、抗Zwb(1例)、伴有HLA抗体的抗Baka(1例)和血型B同种凝集素(1例)。因Bra不相容导致的NAT发生率(19%)仅次于Zwa(78%)。Zwa-NAT临床上更为严重(14%发生颅内出血),对母体血小板输注或静脉注射免疫球蛋白反应良好。在Bra-NAT中未观察到颅内出血,大多数患儿未经特殊治疗即康复。