Neonatal alloimmune thrombocytopenia due to anti-HPA-1b (PLA2)(Zwb). A case report and review.
BACKGROUND
Neonatal alloimmune thrombocytopenia is a rare condition due to passively acquired maternal antibodies directed against paternal platelet antigens inherited by the infant. Only 5 cases have been reported due to antibodies against HPA-1b (PLA2) (Zwb).


METHODS
We report a case of neonatal alloimmune thrombocytopenia due to anti-HPA-1b in the second pregnancy of a 26-year-old Caucasian female. The male infant was treated with a 5-day course of intravenous immunoglobulin without complications. We report the HLA phenotype of the infant's mother and summarize the previous case reports due to anti-HPA-1b.


CONCLUSIONS
Based on this case and a review of the literature, intravenous immunoglobulin as well as random donor exchange transfusion and random donor platelet transfusions are effective in the treatment of neonatal alloimmune thrombocytopenia due to anti-HPA-1b. Obvious associations between HLA alleles and sensitization to HPA-1b have not been elucidated.
Department of Pathology and Laboratory Medicine, University of Kentucky Chandler Medical Center, Lexington, USA. jeffwinters@uky.campus.mci.nei
J L
JL
Winters
C D
CD
Jennings
N S
NS
Desai
L G
LG
Dickson
R F
RF
Ford
D000328:Adult; D016824:Antigens, Human Platelet / Q000276:immunology*; D000939:Epitopes / Q000276:immunology; D005260:Female; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood; D008297:Male; D010641:Phenotype; D011247:Pregnancy; D013921:Thrombocytopenia / Q000276:immunology*
D016824:Antigens, Human Platelet; D000939:Epitopes; D006680:HLA Antigens; D007518:Isoantibodies; C083451:human platelet antigen 1b