title: Primary refractoriness to platelet transfusion caused by Nak(a) antibody alone.
abstract: OBJECTIVE
  Anti-Nak(a), a platelet-specific antibody, occasionally causes platelet-transfusion refractoriness (PTR) together with human leucocyte antigen (HLA) antibodies. Anti-Nak(a) usually appears after frequent platelet transfusions or pregnancy. We report the first case of PTR caused by anti-Nak(a) alone.
  
  
  METHODS
  A 19-year-old male patient with testicular tumour showed PTR when receiving his first transfusion of platelets. Screening for platelet antigens and platelet antibodies revealed that he had type I CD36 (Nak(a)) deficiency and that anti-Nak(a), but not anti-HLA, was present before he received his first transfusion.
  
  
  RESULTS
  The transfusion of Nak(a)-negative, but HLA non-selected, platelets was effective in raising the platelet count.
  
  
  CONCLUSIONS
  Clinically significant Nak(a) antibody was present as naturally occurring antibody in a platelet glycoprotein IV (CD36)-negative non-transfused male patient.
authors.affiliation: Clinical Hematology and Clinical Diagnostics, Graduate School of Medicine, Osaka City University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Fujino
authors.forename: K
authors.initials: K
authors.lastname: Ohta
authors.forename: J
authors.initials: J
authors.lastname: Taniue
authors.forename: N
authors.initials: N
authors.lastname: Nagao
authors.forename: M
authors.initials: M
authors.lastname: Hino
authors.forename: T
authors.initials: T
authors.lastname: Yamane
authors.forename: K R
authors.initials: KR
authors.lastname: Koh
authors.forename: Y
authors.initials: Y
authors.lastname: Takeoka
authors.forename: A
authors.initials: A
authors.lastname: Hirose
authors.forename: Y
authors.initials: Y
authors.lastname: Aoyama
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: T
authors.initials: T
authors.lastname: Takubo
authors.forename: N
authors.initials: N
authors.lastname: Tatsumi
authors.forename: A
authors.initials: A
authors.lastname: Taniue
mesh_terms: D000328:Adult; D016824:Antigens, Human Platelet / Q000276:immunology*; D001792:Blood Platelets / Q000276:immunology; D018955:CD36 Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000009:adverse effects*; D008297:Male; D010976:Platelet Count; D017713:Platelet Transfusion / Q000379:methods*; D013736:Testicular Neoplasms / Q000628:therapy
chemical_list: D016824:Antigens, Human Platelet; D018955:CD36 Antigens; D007518:Isoantibodies; C062601:Naka isoantigen, human