van Leeuwen E F, Pel M
Emma Kinderziekenhuis/het Kinder AMC, Afd. Kindergeneeskunde, Amsterdam.
Ned Tijdschr Geneeskd. 1993 Feb 20;137(8):416-9.
Alloimmunization of the mother against foetal alloantigens can cause neonatal alloimmune thrombocytopenia (NAITP). The recurrence rate is high (90%). The thrombocytopenia in subsequent children is often more severe. Most feared are intracranial haemorrhages (ICH). Current diagnostics indicate that ICH often occurs in utero or during labour. Postnatal therapy is therefore of limited value. We treated three women who had had earlier newborns with severe NAITP, in 5 subsequent pregnancies with weekly high dose intravenous IgG from week 30-34. Four newborns of two women had no thrombocytopenia at birth. Only in one child was the NAITP as severe as in the previous affected sibling. We conclude that antenatal therapy with weekly high dose intravenous IgG is safe and often effective. In utero transfusions are indicated only in exceptional cases.
母亲针对胎儿同种异体抗原的同种免疫可导致新生儿同种免疫性血小板减少症（NAITP）。复发率很高（90%）。后续孩子的血小板减少症往往更严重。最令人担忧的是颅内出血（ICH）。目前的诊断表明，ICH常发生在子宫内或分娩期间。因此，产后治疗价值有限。我们对三名曾有新生儿患严重NAITP的女性进行了治疗，在她们随后的5次妊娠中，从第30至34周开始每周给予大剂量静脉注射免疫球蛋白（IgG）。两名女性的四名新生儿出生时没有血小板减少症。只有一名儿童的NAITP与之前患病的同胞一样严重。我们得出结论，每周大剂量静脉注射IgG进行产前治疗是安全的，而且通常有效。仅在特殊情况下才需要进行宫内输血。
