Foetomaternal Alloimmune
Thrombocytopenia – Evaluation of Diagnostic and Therapeutic Possibilities
Kořínková P., Bolcková H., Vytisková J., Gašová Z., Calda P.
Ústav hematologie a krevní transfuze, Praha Gynekologicko-porodnická klinika VFN, Praha |
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Summary:
Foetomaternal alloimmune thrombocytopenia is a syndrome where the foetus or neonate runs the risk
of haemorrhage, in particular intracranial haemorrhage. The cause of thrombocytopenia is an antibody
of class IgG formed in the mother due to paternal incompatibility. During the last three years of
immunohaematological investigation of neonatal thrombocytopenia in 18 cases an alloimmune cause
was proved and thus the diagnosis of foetomaternal alloimmune thrombocytopenia was confirmed.
During the investigation period already two women were found who expected their second child
running the risk of thrombocytopenia. In more than half the cases the cause was anti-HPA-1a antibody.
The authors recommended and tested in practice a pattern for examination of neonatal thrombocytopenia where an important part is played by assessment of the HPA genotype of the child’s mother and
father: it is possible to predict the level of foetal risk during a subsequent pregnancy. To protect
neonates or foetuses running the risk of intracranial haemorrhage by administration of a suitable
thrombocytic transfusion preparation a panel of donors with an assessed HPA genotype was assembled,
comprising some 350 donors. So far these donors were used in three instances. In one case the
thrombocyte transfusion preparation HPA-1bb was administered by the intrauterine rute.
Key words:
alloimmune thrombocytopenia, frequency of HPA genotypes, thrombocytic antibodies,
antigen negative donors
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