Ueda H, Sugiura T, Katano K, Matsuhashi M, Kato S, Ito K, Nagasaki R, Kato T, Tsuno N H, Saitoh S
Department of Pediatrics and Neonatology, Nagoya, Japan.
Transfus Med. 2015 Feb;25(1):42-6. doi: 10.1111/tme.12178. Epub 2015 Mar 6.
To prevent neonatal alloimmune thrombocytopenia due to anti-group A antibody perinatal management was performed.
We previously reported a case of severe intracranial haemorrhage associated with neonatal alloimmune thrombocytopenia due to anti-group A isoantibody.
MATERIAL/METHODS: A 40-year-old Japanese woman, gravida 4 para 1, was pregnant with her second baby. The previous sibling developed severe thrombocytopenia and died 10 days after birth due to intracranial haemorrhage. He was diagnosed with neonatal alloimmune thrombocytopenia; the causative antibody was found to be the anti-group A antibody. Prednisone was started at 7 weeks' gestational age. Intravenous immunoglobulin 1 g kg(-1) week(-1) was started at 29 weeks' gestational age and continued to delivery. Serological studies and genotyping were performed.
The second boy was delivered at 33 weeks' gestational age by caesarean section. He was discharged without intracranial haemorrhage or thrombocytopenia. The anti-group A antibody titre in the maternal serum was 2048-4096 (normal range: 4-64). The anti-group A antibody titre in the newborn's serum was 4. Cross-matching between the maternal serum and the paternal platelets was positive.
Owing to the history of neonatal alloimmune thrombocytopenia causing intracranial haemorrhage and death of the previous sibling, strict follow-up of the subsequent pregnancy was conducted.
为预防因抗A组抗体导致的新生儿同种免疫性血小板减少症而进行围产期管理。
我们之前报道过一例因抗A组同种抗体导致新生儿同种免疫性血小板减少症并伴有严重颅内出血的病例。
材料/方法：一名40岁的日本女性，孕4产1，怀有二胎。其前一个孩子出现严重血小板减少症，出生后10天因颅内出血死亡。该患儿被诊断为新生儿同种免疫性血小板减少症；致病抗体为抗A组抗体。在孕7周时开始使用泼尼松。在孕29周时开始静脉注射免疫球蛋白，剂量为1 g·kg⁻¹·周⁻¹，持续至分娩。进行了血清学研究和基因分型。
第二个男孩在孕33周时通过剖宫产出生。他出院时没有颅内出血或血小板减少症。母亲血清中的抗A组抗体滴度为2048 - 4096（正常范围：4 - 64）。新生儿血清中的抗A组抗体滴度为4。母亲血清与父亲血小板的交叉配型呈阳性。
由于之前的孩子有因新生儿同种免疫性血小板减少症导致颅内出血并死亡的病史，因此对后续妊娠进行了严格的随访。
