title: [Neonatal alloimmune thrombocytopenic purpura caused by anti-HPA-1a alloantibodies. Case report].
abstract: We report the case of serologically proven HPA-1a NATP. The child was born after uneventful 4th pregnancy. Immediately after birth generalized petechiae and signs of gastrointestinal bleeding were present. Isolated thrombocytopenia with the platelet number of 29 x 10(9)/L was observed. Serological investigation (PSIFT and MAIPA) showed high titre anti-HPA-1a antibody and low titre anti-HLA antibody in mother's sera. Mother's platelets were HPA-1a negative and she was HLA DR 52 positive. Father's platelets were HPA-1a positive. Cross-match between mother's sera and father's platelets was positive. 24 hours after the introduction of corticosteroid therapy platelet number increased to 73 x 10(9)/L and 48 hours later to 155 x 10(9)/L. The child was treated by corticosteroids because the NATP was severe and antigen negative platelets (mother or donor) or IVGG were not available. According to data from the literature the efficiency of corticosteroid therapy in NATP is questionable, but in this case it provided sufficient increase of platelet number with the stop of newborn bleeding.
authors.affiliation: Odjel za imunohematologiju-Odsjek za imunogenetiku trombocita i leukocita, Hrvatski zavod za transfuzijsku medicinu, Petrova 3, 10000 Zagreb.
authors.forename: M
authors.initials: M
authors.lastname: Tomicić
authors.forename: M
authors.initials: M
authors.lastname: Deković
authors.forename: J
authors.initials: J
authors.lastname: Jaksić
authors.forename: E
authors.initials: E
authors.lastname: Stoini
authors.forename: V
authors.initials: V
authors.lastname: Drazić
authors.forename: B
authors.initials: B
authors.lastname: Grahovac
authors.forename: Z
authors.initials: Z
authors.lastname: Hundrić-Haspl
authors.forename: T
authors.initials: T
authors.lastname: Vuk
authors.forename: D
authors.initials: D
authors.lastname: Grgicević
mesh_terms: D016824:Antigens, Human Platelet / Q000276:immunology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D039661:Integrin beta3; D007518:Isoantibodies / Q000032:analysis*; D008297:Male; D011247:Pregnancy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000151:congenital* / Q000276:immunology / Q000628:therapy
chemical_list: D016824:Antigens, Human Platelet; C061248:ITGB3 protein, human; D039661:Integrin beta3; D007518:Isoantibodies