Proskuriakova Ekaterina, Upreti Shikha, Wortsman Joshua, Alkhaurri Bashar, Rosendale Jacob, Kassem Mohammed, Khosla Pam
Internal Medicine, Mount Sinai Hospital, Chicago, USA.
Internal Medicine, Ross University School of Medicine, St. Michael, BRB.
Cureus. 2023 Nov 30;15(11):e49736. doi: 10.7759/cureus.49736. eCollection 2023 Nov.
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare, life-threatening condition causing significant thrombocytopenia and bleeding with the risk of developing intracerebral hemorrhage (ICH). It results from maternal immunizations against fetal platelet antigens. Here, we report a case of a pregnant patient at 30 weeks gestation who presented to the hospital with a low platelet count of 90 th/mm and was found to have anti-human platelet antigen (HPA) 1a, 2b antibodies. She was treated with a weekly infusion of IV immunoglobulins. However, her condition was complicated by the development of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, which was treated promptly with a platelet transfusion and intravenous magnesium. Even though the child had severe thrombocytopenia and its associated complications, there were no signs of post-delivery thrombocytopenia or any other adverse effects. This case report highlights the importance of the antenatal management of the FNAIT to prevent severe fetal complications, such as ICH.
胎儿和新生儿同种免疫性血小板减少症(FNAIT)是一种罕见的、危及生命的疾病,可导致严重的血小板减少和出血,并伴有发生脑出血(ICH)的风险。它是由母体针对胎儿血小板抗原的免疫反应引起的。在此,我们报告一例妊娠30周的孕妇病例,该孕妇因血小板计数低至90×10⁹/L入院,被发现存在抗人血小板抗原(HPA)1a、2b抗体。她接受了每周一次的静脉注射免疫球蛋白治疗。然而,她的病情因溶血、肝酶升高和血小板减少(HELLP)综合征的出现而复杂化,通过输注血小板和静脉注射镁进行了及时治疗。尽管婴儿有严重的血小板减少及其相关并发症,但产后没有血小板减少的迹象或任何其他不良反应。本病例报告强调了FNAIT产前管理对预防严重胎儿并发症(如ICH)的重要性。