Neonatal alloimmune thrombocytopenia caused by anti‐HLA‐A24 alloantibodies

Starčević, Mirta; Tomičić, Maja; Malenica, Maša; Zah-Mataković, Vanja

doi:10.1111/j.1651-2227.2009.01599.x

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…The antigens that lead to a higher rate of immunisation compared to other antigens in the respective loci were A*2, B*49, B*51 and C*15. Interestingly, antibodies reactive with these alleles were also common among our cases, as were the assumed causative antibodies from previously mentioned case reports, like A*24 (Starcevic et al , ), A*2 (Gramatges et al , ) and B*27 (Thude et al , ).…”

Section: Discussionsupporting

confidence: 80%

“…Reviews and meta‐analyses on the effects of HLA class I antibodies in pregnancy, and as cause of neonatal thrombocytopenia, have been inconclusive (Lashley et al , ) or dismissive, (Taaning, ) and earlier prospective studies fail to determine any certain associations (Sharon and Amar, ; King et al , ). Still, there are several reports of suspected cases of FNAIT with HPA‐1a antigen positive mothers and HLA class I antibodies as the only serological finding, even after antibodies against rare HPAs have been excluded (Thude et al , ; , Hutchinson et al, ; Starcevic et al , ).…”

mentioning

confidence: 99%

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Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Refsum

Mörtberg

Dahl

et al. 2016

Transfusion Medicine

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Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Refsum

Mörtberg

Dahl

et al. 2016

Transfusion Medicine

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“…94,95 Interestingly, cases of NAIN and NAIT associated with maternal HLA class I antibodies have also been well-documented, indicating that HLA sensitization of the mother is a mechanism of disease in the fetus. 96–99 …”

Section: Discussionmentioning

confidence: 99%

Maternal HLA Panel-Reactive Antibodies in Early Gestation Positively Correlate with Chronic Chorioamnionitis: Evidence in Support of the Chronic Nature of Maternal Anti-fetal Rejection

Lee

Romero

et al. 2011

American Journal of Reproductive Immunology

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Problem Maternal tolerance of the fetus is essential for viviparity, yet anti-fetal rejection occurs in several pregnancy complications. Chronic chorioamnionitis (CCA) is a feature of anti-fetal cellular rejection. There is a robust association between CCA and maternal seropositivity for anti-HLA panel reactive antibodies (PRA) at the time of delivery. This longitudinal study was performed to assess maternal HLA PRA status in early gestation and the temporal evolution of maternal HLA PRA in the context of CCA and thereby to determine whether HLA PRA during the course of pregnancy is useful for the detection of anti-fetal rejection. Method of Study Maternal sera obtained before 16 weeks of gestation and at delivery were analyzed for HLA panel reactive antibodies (PRA) in cases with (N=100) and without (N=150) CCA. Results IgG but not IgM HLA class I and II PRA positivity at delivery was higher in cases with CCA than in those without CCA. IgG HLA class I PRA positivity before 16 weeks of gestation was higher in cases with CCA than in those without (30.3% vs. 13.3%; p=0.001). Positive conversion (negative HLA PRA before 16 weeks of gestation but positive at delivery) of IgG HLA class I and II PRA was significantly associated with CCA. Fetal HLA class I antigen-specific antibodies were confirmed in 12 of 16 mothers tested who were sensitized to HLA class I antigens before 16 weeks of gestation. Conclusion Positive maternal HLA PRA before 16 weeks of gestation and the temporal evolution of maternal HLA PRA are associated with the presence of CCA at the time of delivery. Maternal IgG HLA PRA has potential to be a monitoring tool of anti-fetal rejection. Furthermore, the findings herein indicate that subsets of fetuses are exposed to alloimmune HLA antibodies for months, especially in cases with CCA.

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“…In humans, MHC class I alloantibodies in individual cases of fetal/neonatal alloimmune thrombocytopenia (FNAIT) have been reported a number of times during the past decades (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). In addition to thrombocytopenia, the presence of an associated neutropenia is noticed in a few cases (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

Foucras

Corbière

Tasca

et al. 2011

The Journal of Immunology

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Fetal/neonatal alloimmune thrombocytopenia is a frequent disease in humans where alloantibodies against platelet Ags lead to platelet destruction and hemorrhage. Although a role in the disease for Abs against MHC has been suspected, this has not been formally demonstrated. Since 2007, a hemorrhagic syndrome due to thrombocytopenia and designated as bovine neonatal pancytopenia (BNP) has been recognized in calves in several European countries. An inactivated antiviral vaccine is strongly suspected to be involved in this syndrome because of its highly frequent use in the dams of affected calves. In this study, we show that BNP is an alloimmune disease, as we reproduced the signs by transferring serum Abs from vaccinated BNP dams into healthy neonatal calves. Ab specificity was strongly associated with the presence of allogeneic MHC class I Abs in the dams. MHC class I staining was also observed on Madin–Darby bovine kidney cells, a cell line related to the one used to produce the vaccine Ag. Our report emphatically demonstrates that alloimmunization against MHC class I is associated with a substantial risk of developing cytopenia-associated syndromes in neonates when a cell line of the same species is used to produce an inactivated vaccine injected into the mother.

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Neonatal alloimmune thrombocytopenia caused by anti‐HLA‐A24 alloantibodies

Abstract: This case supports the idea that some anti-HLA class I antibodies could cause NAIT.

Cited by 17 publications

References 15 publications

Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Maternal HLA Panel-Reactive Antibodies in Early Gestation Positively Correlate with Chronic Chorioamnionitis: Evidence in Support of the Chronic Nature of Maternal Anti-fetal Rejection

Alloantibodies against MHC Class I: A Novel Mechanism of Neonatal Pancytopenia Linked to Vaccination

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