Fetal and neonatal alloimmune thrombocytopenia: progress and ongoing debates.
Fetal and neonatal alloimmune thrombocytopenia (AIT) is a result of a parental incompatibility of platelet-specific antigens and the transplacental passage of maternal alloantibodies against the platelet antigen shared by the father and the fetus. It occurs in approximately 1 in 1000 live births and is the most common cause of severe thrombocytopenia in fetuses and term neonates. As screening programs are not routinely performed, most affected fetuses are identified after birth when neonatal thrombocytopenia is recognized. In severe cases, the affected fetus is identified as a result of suffering from an in utero intracranial hemorrhage. Once diagnosed, AIT must be treated antenatally as the disease can be more severe in subsequent pregnancies. While there have been many advances regarding the diagnosis and treatment of AIT, it is still difficult to predict the severity of disease and which therapy will be effective.
Bussel
James B
JB
Division of Hematology, Department of Pediatrics, Weill Medical College of Cornell University, New York, NY 10021-4853, United States. jbussel@med.cornell.edu
Primiani
Andrea
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D016824:Antigens, Human Platelet / Q000276:immunology; D001805:Blood Transfusion, Intrauterine; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000276:immunology / Q000628:therapy; D017713:Platelet Transfusion / Q000379:methods; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000276:immunology*; D011296:Prenatal Diagnosis / Q000379:methods; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D016824:Antigens, Human Platelet; D016756:Immunoglobulins, Intravenous