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Primary refractoriness to platelet transfusion caused by Nak(a) antibody alone
1Clinical Hematology and Clinical Diagnostics, Graduate School of Medicine, Osaka City University, Japan.
Background And Objectives:
Anti-Nak(a), a platelet-specific antibody, occasionally causes platelet-transfusion refractoriness (PTR) together with human leucocyte antigen (HLA) antibodies. Anti-Nak(a) usually appears after frequent platelet transfusions or pregnancy. We report the first case of PTR caused by anti-Nak(a) alone.
Materials And Methods:
A 19-year-old male patient with testicular tumour showed PTR when receiving his first transfusion of platelets. Screening for platelet antigens and platelet antibodies revealed that he had type I CD36 (Nak(a)) deficiency and that anti-Nak(a), but not anti-HLA, was present before he received his first transfusion.
Results:
The transfusion of Nak(a)-negative, but HLA non-selected, platelets was effective in raising the platelet count.
Conclusion:
Clinically significant Nak(a) antibody was present as naturally occurring antibody in a platelet glycoprotein IV (CD36)-negative non-transfused male patient.