Neonatal alloimmune neutropenia in premature monozygous twins.
Alloimmune neonatal neutropenia (ANN) is an uncommon but potentially life-threatening disorder of the neonate and young infant. Hematologically, the mother's peripheral neutrophil count is normal. However, the passive transfer of maternal immunoglobulin G neutrophil-specific antibodies and the subsequent sensitization of fetal neutrophils can result in severe neutropenia in the neonate. Generally, ANN is a self-limiting condition, but with severe bacterial infection, mortality can be high. We present the clinical features of monozygous twins delivered at 33 weeks' postconception with this condition. This case report is unique in that it occurred in twins born prematurely and was attributable to antibodies against 2 neutrophil-specific antigens, NA1 and NB1. A brief review of the diagnosis, management, and treatment of ANN is presented.
Pediatrix Medical Group, Inc., Arnot Ogden Medical Center, Elmira, NY 14905, USA.
J K
JK
Felix
D A
DA
Calhoun
D000918:Antibody Specificity / Q000235:genetics / Q000276:immunology; D001787:Blood Group Incompatibility / Q000235:genetics* / Q000276:immunology / Q000628:therapy; D004200:Diseases in Twins / Q000235:genetics*; D005260:Female; D058851:GPI-Linked Proteins; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007116:Immunization, Passive; D007074:Immunoglobulin G / Q000097:blood / Q000235:genetics; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000235:genetics* / Q000276:immunology / Q000628:therapy; D007518:Isoantibodies / Q000097:blood / Q000235:genetics*; D007519:Isoantigens / Q000235:genetics / Q000276:immunology; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics / Q000276:immunology; D009503:Neutropenia / Q000235:genetics* / Q000276:immunology / Q000628:therapy; D009504:Neutrophils / Q000276:immunology*; D011247:Pregnancy; D011956:Receptors, Cell Surface; D011994:Recombinant Proteins; D014430:Twins, Monozygotic
C407242:CD177 protein, human; D058851:GPI-Linked Proteins; D007074:Immunoglobulin G; D007518:Isoantibodies; D007519:Isoantigens; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D011994:Recombinant Proteins; C067704:neutrophil-specific antigen NA1, human; D016179:Granulocyte Colony-Stimulating Factor