Fetal genotyping for platelets antigens: a precise tool for alloimmune thrombocytopenia: case report and literature review.
BACKGROUND
Maternal-fetal alloimmune thrombocytopenia complicates about 0.1% of all pregnancies and is associated with major fetal and neonatal morbidity and mortality, especially spontaneous central nervous system bleeding leading to death and neurological handicaps. Successful prevention and treatment depend on the identification of at-risk possible carriers of anti-platelet antibodies.


METHODS
We report a case of a mother with a previous child that developed neonatal hemorrhage; HPA-5b anti-platelet antibodies were detected post-natally. During the next pregnancy, fetal genotyping confirmed the presence of HPA-5b antigen; she was treated with weekly intravenous human immunoglobulin and oral prednisone. Pregnancy evolved without remarkable features and a full-term baby was delivered, with normal platelet counts.


CONCLUSIONS
Fetal alloimmune thrombocytopenia is a potentially lethal condition, but early detection and prevention lead to successful outcome in most cases.
Nomura
Marcelo Luís
ML
Hematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária, CEP 13084-881 Campinas, SP, Brazil. mlnomura@unicamp.br
Couto
Egle
E
Martinelli
Beatriz Moraes
BM
Barjas-Castro
Maria Lourdes
ML
Barini
Ricardo
R
Passini Júnior
Renato
R
Castro
Vagner
V
D016824:Antigens, Human Platelet / Q000235:genetics / Q000276:immunology*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007231:Infant, Newborn; D007519:Isoantigens / Q000276:immunology*; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D011247:Pregnancy; D013921:Thrombocytopenia / Q000000981:diagnostic imaging / Q000235:genetics / Q000276:immunology* / Q000517:prevention & control; D016216:Ultrasonography, Prenatal
C451327:5b antigen; D016824:Antigens, Human Platelet; D016756:Immunoglobulins, Intravenous; D007519:Isoantigens; D011241:Prednisone