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Neonatal alloimmune thrombocytopenia due to anti-HPA-1b (PLA2)(Zwb). A case report and review
J L Winters1, C D Jennings, N S Desai
1Department of Pathology and Laboratory Medicine, University of Kentucky Chandler Medical Center, Lexington, USA. jeffwinters@uky.campus.mci.nei
Background:
Neonatal alloimmune thrombocytopenia is a rare condition due to passively acquired maternal antibodies directed against paternal platelet antigens inherited by the infant. Only 5 cases have been reported due to antibodies against HPA-1b (PLA2) (Zwb).
Case Report:
We report a case of neonatal alloimmune thrombocytopenia due to anti-HPA-1b in the second pregnancy of a 26-year-old Caucasian female. The male infant was treated with a 5-day course of intravenous immunoglobulin without complications. We report the HLA phenotype of the infant's mother and summarize the previous case reports due to anti-HPA-1b.
Conclusion:
Based on this case and a review of the literature, intravenous immunoglobulin as well as random donor exchange transfusion and random donor platelet transfusions are effective in the treatment of neonatal alloimmune thrombocytopenia due to anti-HPA-1b. Obvious associations between HLA alleles and sensitization to HPA-1b have not been elucidated.
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