Primary refractoriness to platelet transfusion caused by Nak(a) antibody alone.
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.
Fujino
H
H
Clinical Hematology and Clinical Diagnostics, Graduate School of Medicine, Osaka City University, Japan.
Ohta
K
K
Taniue
J
J
Nagao
N
N
Hino
M
M
Yamane
T
T
Koh
K R
KR
Takeoka
Y
Y
Hirose
A
A
Aoyama
Y
Y
Nakamae
H
H
Terada
Y
Y
Takubo
T
T
Tatsumi
N
N
Taniue
A
A
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
D016824:Antigens, Human Platelet; D018955:CD36 Antigens; D007518:Isoantibodies; C062601:Naka isoantigen, human