open access

Vol 48, No 2 (2017)
Prace poglądowe / Reviews
Published online: 2017-04-01
Submitted: 2016-11-22
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Fetal and neonatal alloimmune thrombocytopenia

Irmina Nowak1, Weronika Kubiak-Prałat1, Marcin Minta1, Marta Szymankiewicz2, Janusz Gadzinowski2, Dawid Szpecht2
DOI: 10.1016/j.achaem.2017.01.004
·
Acta Haematol Pol 2017;48(2):119-124.
Affiliations
  1. Chair and Department of Anaesthesiology and Intensive Care, Poznan University of Medical Sciences, Poznan, Poland
  2. Chair and Department of Neonatology, Poznan University of Medical Sciences, Poland

open access

Vol 48, No 2 (2017)
Prace poglądowe / Reviews
Published online: 2017-04-01
Submitted: 2016-11-22

Abstract

Fetal/neonatal alloimmune thrombocytopenia (FNAIT) is defined as a platelet count <150,000/μL due to reaction between maternal antibodies and antigens located on thrombocytes of the fetus/neonate. Such a kind of pathology occurs when a mother does not possess specific human platelet antigens (HPA), which are inherited as an infant from the father. HPA-1a is an antigen that most often causes FNAIT in the Caucasian race. Frequency of FNAIT has been estimated as 1:350–1:5000. In the pathogenesis of FNAIT, the mother organism is immunized and produces alloantibodies from which IgG pass through the placenta, enter fetal circulatory system and cause platelet destruction. It usually takes place at the end of the second trimester. FNAIT can occur in the first pregnancy; nonetheless, it is more probable and connected with higher severity in subsequent gestations. It is caused by the fact that immunization usually takes place during the first labour, which enables production of alloantibodies in the next pregnancies. Nevertheless, other ways of immunization are also possible, which ensures that FNAIT cases in the first pregnancy are not casuistic and occur more often than RhD hemolytic disease of the newborn. Thrombocytopenia leads to coagulation disorders, and consequently to bleedings. FNAIT can be manifested not only by some petechiae on the skin, but also by severe hemorrhages in the body cavities and gastrointestinal tract or by intracranial hemorrhages (ICH). In case the symptoms are presented by an infant, platelet transfusions are performed, and IVIG (intravenous immunoglobulin) therapy is administered.

Abstract

Fetal/neonatal alloimmune thrombocytopenia (FNAIT) is defined as a platelet count <150,000/μL due to reaction between maternal antibodies and antigens located on thrombocytes of the fetus/neonate. Such a kind of pathology occurs when a mother does not possess specific human platelet antigens (HPA), which are inherited as an infant from the father. HPA-1a is an antigen that most often causes FNAIT in the Caucasian race. Frequency of FNAIT has been estimated as 1:350–1:5000. In the pathogenesis of FNAIT, the mother organism is immunized and produces alloantibodies from which IgG pass through the placenta, enter fetal circulatory system and cause platelet destruction. It usually takes place at the end of the second trimester. FNAIT can occur in the first pregnancy; nonetheless, it is more probable and connected with higher severity in subsequent gestations. It is caused by the fact that immunization usually takes place during the first labour, which enables production of alloantibodies in the next pregnancies. Nevertheless, other ways of immunization are also possible, which ensures that FNAIT cases in the first pregnancy are not casuistic and occur more often than RhD hemolytic disease of the newborn. Thrombocytopenia leads to coagulation disorders, and consequently to bleedings. FNAIT can be manifested not only by some petechiae on the skin, but also by severe hemorrhages in the body cavities and gastrointestinal tract or by intracranial hemorrhages (ICH). In case the symptoms are presented by an infant, platelet transfusions are performed, and IVIG (intravenous immunoglobulin) therapy is administered.

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Keywords

Newborn; Thrombocytopenia; Alloimmunization

About this article
Title

Fetal and neonatal alloimmune thrombocytopenia

Journal

Acta Haematologica Polonica

Issue

Vol 48, No 2 (2017)

Pages

119-124

Published online

2017-04-01

DOI

10.1016/j.achaem.2017.01.004

Bibliographic record

Acta Haematol Pol 2017;48(2):119-124.

Keywords

Newborn
Thrombocytopenia
Alloimmunization

Authors

Irmina Nowak
Weronika Kubiak-Prałat
Marcin Minta
Marta Szymankiewicz
Janusz Gadzinowski
Dawid Szpecht

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