Nakamura Toshihiko, Nomura Tomoaki, Kamohara Takashi, Takahashi Hidehiro, Hatanaka Daisuke, Kusakari Michiko, Nakamura Mari, Kawabata Kinuyo, Ohto Hitoshi
Department of Neonatology, Japanese Red Cross Musashino Hospital.
Fukushima J Med Sci. 2015;61(2):149-54. doi: 10.5387/fms.2015-19. Epub 2015 Dec 3.
Anti-HLA antibodies reportedly exist in the one third of pregnant women. But few occurrences of neonatal alloimmune thrombocytopenia (NAIT) caused by anti-HLA antibodies have been reported. Here a male baby, who was admitted for low birth weight with Down syndrome (DS), was suffered from thrombocytopenia without transient myeloproliferative disorder (TMD). Positive reactions of HLA-specific antibodies were detected in maternal serum. Cross-matching tests between maternal serum and paternal platelets and lymphocytes were strongly positive. It is most conceivable that the previous pregnancy of the mother induced the production of anti-HLA-A2 antibody, which crossed the placenta and subsequently caused an NAIT in the case presented. This is the first case of DS with NAIT due to anti-HLA antibodies.
据报道，三分之一的孕妇体内存在抗HLA抗体。但由抗HLA抗体引起的新生儿同种免疫性血小板减少症（NAIT）的病例报告较少。在此报告一例男婴，因低出生体重伴唐氏综合征（DS）入院，患有血小板减少症且无短暂性骨髓增殖性疾病（TMD）。在母体血清中检测到HLA特异性抗体呈阳性反应。母体血清与父体血小板和淋巴细胞之间的交叉配型试验呈强阳性。最有可能的是，母亲之前的妊娠诱导产生了抗HLA - A2抗体，该抗体穿过胎盘，随后在本病例中导致了NAIT。这是首例因抗HLA抗体导致DS合并NAIT的病例。
