title: Alloimmune thrombocytopenia in the fetus and newborn.
abstract: Alloimmune thrombocytopenia is an interesting and challenging disease. Identification in the fetus and newborn by screening remains to be clarified. The primary clinical criterion for neonatal diagnosis appears to be a neonatal platelet count of <50 x 10(9)/L. Treatment of the neonate can be accomplished with intravenous immunoglobulin (IVIG) +/- steroids or with matched platelet transfusion. Cranial ultrasonography is important. Testing can be performed on the parents and requires a highly experienced laboratory. If an affected fetus is identified, based on a previous affected neonate and a homozygous father, antenatal management is needed. Studies have been completed that inform the still controversial decision. IVIG remains the basis of therapy but appears to require a higher dose (2 g/kg/week) and/or the addition of 1 mg/kg of prednisone in the highest risk cases, those with antenatal intracranial hemorrhage.
authors.affiliation: Division of Pediatric Hematology/Oncology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York 10021, USA. jbussel@med.cornell.edu
authors.forename: J B
authors.initials: JB
authors.lastname: Bussel
mesh_terms: D016824:Antigens, Human Platelet / Q000276:immunology; D005260:Female; D005315:Fetal Diseases / Q000097:blood / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000276:immunology; D007519:Isoantigens / Q000276:immunology; D015997:Neonatal Screening; D011247:Pregnancy; D011296:Prenatal Diagnosis; D013921:Thrombocytopenia / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy
chemical_list: D016824:Antigens, Human Platelet; D007519:Isoantigens