[Alloimmune neonatal neutropenia: clinical observations and therapeutic results]

Alloimmune neonatal neutropenia is a rare disease. A family with four affected newborns is described in which the course of the disease aggravated from the first to the third child. The third child died from generalized infection. In the mother's serum specific antibodies against neutrophils (anti-NA 1) were detected which reacted with cell suspensions from the father and the other children. In the fourth child no neutrophils were present even immediately after birth. In this child the diaplacental transferred antibodies were detectable in falling concentrations over 8 weeks. The number of neutrophils normalized when the antibodies disappeared. Infection in the newborn was prevented by care in an environment poor in bacteria and by antimicrobial prophylaxis. Repeated exchange transfusions with NA 1-free blood only lowered the antibody titer. Transfusions of white blood cell concentrates had only shortlived effects on the neutropenia.