Hospital Dexeus, Pediatrics-Neonatology, Barcelona, Catalonia, Spain.
Hospital Dexeus, Pediatrics-Neonatology, Barcelona, Catalonia, Spain.
Transfus Apher Sci. 2020 Dec;59(6):102880. doi: 10.1016/j.transci.2020.102880. Epub 2020 Jul 22.
The most frequently involved antigen in severe fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the human platelet antigen 1a. Cases of FNAIT caused by HPA-5a antigen are extremely rare, and usually not severe. We report a case of FNAIT caused by anti-HPA antibodies directed to the HPA-5a antigen. The thrombocytopenia was moderate with a minimal platelet count of 36 × 10/L by day 3, and spontaneously resolved by day 10. The pregnancy had been obtained by in vitro fertilization using embryo donation, creating a complete genetic disparity between the HPA 5b5b mother and the HPA 5a5a homozygous neonate. The use of ART with gamete donation can increase the risk and the severity of alloimmune thrombocytopenia and must be considered in new and subsequent pregnancies.
最常涉及严重胎儿和新生儿同种免疫性血小板减少症（FNAIT）的抗原是人血小板抗原 1a。由 HPA-5a 抗原引起的 FNAIT 病例极为罕见，且通常不严重。我们报告了一例由针对 HPA-5a 抗原的抗 HPA 抗体引起的 FNAIT。血小板减少症为中度，第 3 天血小板计数最低为 36×10/L，第 10 天自发缓解。该妊娠是通过使用胚胎捐赠的体外受精获得的，这使得 HPA 5b5b 母亲和 HPA 5a5a 纯合子新生儿之间存在完全的遗传差异。配子捐赠的 ART 的使用会增加同种免疫性血小板减少症的风险和严重程度，在新的和随后的妊娠中必须加以考虑。
