[Anti Ko(a) as a cause of neonatal alloimmune thrombocytopenia]

Neonatal alloimmune thrombocytopenia (NAIT) is caused by maternal immunization against a paternal antigen on fetal platelets. The antigens mostly involved are Zwa (PlA1) and Br(a). The Ko alloantigen system which is localized on the N-terminal region of glycoprotein Ib usually causes antibody formation in polytransfused patients but is only rarely implicated in NAIT. Ko(a) antibodies raised in the mother of a thrombocytopenic newborn were shown to be detectable by platelet agglutination and MAIPA assay if the antigen-bearing N-terminal glycocalicin is protected from proteolytic degradation.