Fetoneonatal alloimmune thrombocytopenia (FNAIT): Our experience

Fetoneonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare clinical syndrome characterized by marked thrombocytopenia shortly after birth. It occurs when fetal platelets are destroyed, after sensitization, by a transplacental passage of maternal antibodies directed against a fetal platele...

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Bibliographic Details
Published in:Transfusion and apheresis science 2006-10, Vol.35 (2), p.111-117
Main Authors: Fratellanza, Giorgio, Fratellanza, Annagrazia, Paesano, Luigi, Scarcella, Alda, Safoian, Alexander, Misso, Saverio, Formisano, Salvatore, Scarpato, Nicola
Format: Article
Language:English
Subjects:
Alleles
Autoantibodies - blood
Autoantibodies - genetics
Autoantibodies - immunology
Female
Fetomaternal immunization
FNAIT
Health technology assessment
Humans
Infant, Newborn
Isoantigens - blood
Isoantigens - genetics
Isoantigens - immunology
Male
NAITP
Platelet antigen
Platelet Membrane Glycoproteins - analysis
Platelet Membrane Glycoproteins - genetics
Platelet Membrane Glycoproteins - immunology
Retrospective Studies
Thrombocytopenia
Thrombocytopenia - blood
Thrombocytopenia - congenital
Thrombocytopenia - diagnosis
Thrombocytopenia - immunology
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Summary:Fetoneonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare clinical syndrome characterized by marked thrombocytopenia shortly after birth. It occurs when fetal platelets are destroyed, after sensitization, by a transplacental passage of maternal antibodies directed against a fetal platelet alloantigen inherited from the father. This article reviews some pathophysiologic and clinical aspects of FNAIT. We also present our experience with the management of 12 newborns affected with a symptomatic form of this disorder in order to verify what would be the best diagnostic and therapeutic protocols. Antibody identification in maternal serum showed 9 anti-HPA-1a (75% of cases), 2 anti-HPA-1b (17%) and 1 anti-HPA-1a + anti-Gp IV + anti-HLA class I (8%). Sixteen human platelet alloantigen (HPA) systems have been identified, six major (from HPA 1 to 5 and HPA 15) and ten rare or private, each composed of two allelic antigens (named “a” or “b”, according to major or minor frequency in the population). All HPA systems, including private or low frequency, may play a role in determining FNAIT. Unfortunately FNAIT cannot be prevented, in fact no one of maternal parameters is predictive of thrombocytopenia or its magnitude.
ISSN:1473-0502
1878-1683
DOI:10.1016/j.transci.2006.07.005