[Intracraneal hemorrhage caused by neonatal alloimmune thrombocytopenia. Report of a case and review].
BACKGROUND
Neonatal alloimmune thrombocytopenia (NAT) is due to the transplacental transfer of circulating maternal alloantibodies developed against fetal platelet antigens inherited from the father. Intracranial hemorrhage occurs in 15-30% of the cases, and very important neurological sequelaes can be due to it.


METHODS
We present the clinical and immunohematologic findings of a case of severe NAT that had two siblings who died by this illness. In the 31st week of gestation an intracranial hemorrhage is detected by echography, the birth was by caesarean section. Apgar score of 8 and 9, it wasn't necessary reanimation procedures. Cutaneous purpura and pallor were presented since birth. Neonatal complete blood count showed a platelet count of 6,000/mm3 (whereas maternal blood count was normal), haemoglobin of 8.8 g/dL and hematocrit of 26.1%, without other biological alterations. In maternal blood alloantibodies antiHPA-1a were detected, being the father homozigous for 1a/1a and the mother homozigous for 1b/1b. The patient was treated with transfusions, endovenous gammaglobulin and corticosteroids and his condition improved.


CONCLUSIONS
Intraparenchymatous hemorrhage is an uncommon pathology in neonates, but when this occurs it's obligated to rule out a coagulation inherited illness, NTA especially, because of its prevalence and potentially serious neurological sequelaes, sometimes having a good neurological development. Prevention, early treatment and neuroimaging studies should be done in all newborn babies with alloimmune thrombocytopenia even when no neurological clinic is seen.
Lou-Francés
G
G
Unidad Neonatal, Hospital Universitario Miguel Servet, 50009 Zaragoza, Espana.
Pascual-Sánchez
M
M
Jiménez-Fernández
M
M
Echeverría-Matía
I
I
López-Pisón
J
J
Marco-Tello
A
A
Rebage
V
V
D016824:Antigens, Human Platelet / Q000276:immunology; D005260:Female; D005315:Fetal Diseases / Q000276:immunology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000473:pathology; D007518:Isoantibodies / Q000276:immunology; D008297:Male; D008431:Maternal-Fetal Exchange / Q000276:immunology; D011247:Pregnancy; D013921:Thrombocytopenia / Q000150:complications / Q000276:immunology
D016824:Antigens, Human Platelet; D007518:Isoantibodies