[Neonatal autoimmune purpura: laboratory study of 5 cases]

Maternal alloimmunization against fetal platelets can cause fetal and neonatal thrombocytopenia. We report our experience in the study of five cases with severe neonatal-thrombocytopenia. Using an ELISA with antigen capture and other serologic tests on platelets, we investigated the sera of the five mothers. Sera from four mothers contained a platelet-specific alloantibody, anti-HPA-1a (PlA1) whereas the platelets typed as HPA-1b/b. In one case despite extensive serological investigation and clinically unequivocal diagnosis of AINT, no antibodies were demonstrated. The use of monoclonal antibodies for antigen immobilization, showed to be a reliable and sensitive test for the detection and identification of platelet antibodies in AINT. These techniques could also be used in the follow-up of patients at risk (e.g. pregnant HPA-1b/b women) and in the screening of blood donors lacking of certain antigens, whose platelets are collected to be transfused in patients with platelet-specific antibodies.