ABSTRACT
Neonatal alloimmune thrombocytopenia (NAIT) was first described in the 1950s. The disease results from maternal antiplatelet antibodies against surface antigens on fetal platelets due to feto-maternal platelet incompatibility. Although NAIT is transient, during its active phase thrombocytopenia can cause intracranial hemorrhage with grave neurological sequelae or death. We characterized the alloimmune antibodies in 29 mothers and found anti-HPA-1a (in 11 cases), anti-HPA1b (1), anti-HPA-5a (1) and anti-HPA-5b (5). In 11 women no specific antibodies were identified despite characteristic disease in the newborns. 3 neonates in the anti-HPA-1a, and 1 in the anti-HPA-1b groups were born with intracranial hemorrhage and are severely disabled. We described a case of successful prenatal treatment by a combination of steroids, high-dose immunoglobulins and intraumbilical platelet transfusion in a mother known to have anti-HPA-1, whose previous child was severely affected. It is important to examine antibodies in any woman whose neonate has thrombocytopenia of unknown etiology.
