Anti-HLA antibodies reportedly exist in 31% of pregnant women. However, few ocurrences of neonatal alloimmune thrombocytopenia (NAIT) caused by anti-HLA antibody have been reported. In this study, maternal anti-HLA B60 and B61 antibodies were identified in patient serum at birth, but no anti-platelet antibodies were present. No maternal anti-HLA A2, A24, B51, or B52 antibodies were detected in patient serum. Platelet transfusion from the third donor was effective because these platelets expressed HLA A24 and B52 but not B60 or B61. Cross-matching tests between patient leukocytes or platelets and maternal serum were strongly positive, indicating that maternal anti-HLA antibodies were responsible for NAIT. This report is the first to demonstrate NAIT probably caused by maternal anti-HLA A24 and B52.

We have reported a rare case of auto anti-E antibody with specificity mimicking alloantibody with E specificity. A patient whose red cells typed as R1R1 and who had a positive direct antiglobulin test was admitted to our hospital. After standard serologic testing was performed, flow cytometry, Western blot analysis and differential allogenic adsorption test were used to verify whether antibody binds to the patient's red cells and normal red cells. A high titer anti-E antibody was detected transiently from the patient's serum and eluate. An indirect antiglobulin test using red cells treated by cysteine-activated papain and dithiothreitol (ZZAP) and chloroquine showed that both the patient's serum and eluate bound an apparent anti-E antibody to E negative patient's red cells. Fluorescence activated cells sorter (FACS) and Western blot analysis verified that the patient's red cells lacked E antigen. Further, it was clarified that the antibody does not bind to any E negative normal red cells by differential allogenic adsorption test. These results provide evidence that an antibody mimicking an E alloantibody can bind to patient's own E negative red cells but not to allogenic E negative red cells.

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