Neonatal alloimmune thrombocytopeniadue to anti‐Nak<sup>a</sup>

Kankirawatana, Suthida; Kupatawintu, Pavinee; Juji, Takeo; Veerakul, Gavivann; Ngerncham, Sopapan; Chongkolwatana, Viroje; O-Charoen, Rachanee

doi:10.1046/j.1537-2995.2001.41030375.x

Cited by 31 publications

(35 citation statements)

References 15 publications

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“…1). These observations are basically consistent with reports that maternal anti‐CD36 isoantibody transferred to the fetus can cause neonatal alloimmune thrombocytopenia 16,17 . Actually, the two sons of the donor were born with thrombocytopenia and anemia.…”

Section: Resultssupporting

confidence: 92%

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody

et al. 2005

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Section: Resultssupporting

confidence: 92%

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody

et al. 2005

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“…28 Interestingly, variable clinical pictures of FNAIT mediated by anti-CD36 isoantibodies, including mild and severe thrombocytopenia, hydrops fetalis, and recurrent abortions, have been observed. [9][10][11][12][13]29 However, the precise mechanism of this phenomenon is not known.…”

Section: Discussionmentioning

confidence: 99%

“…6 The clinical importance of anti-CD36 isoantibodies in the development of FNAIT has been reported in different populations. [9][10][11][12][13] Currently, the antigen-capture assay represents the gold standard for detecting platelet antibodies. 14 With this assay, platelet antigens captured by mouse monoclonal antibody are used as the target for platelet antibodies.…”

mentioning

confidence: 99%

Fetal/neonatal alloimmune thrombocytopenia due to anti‐CD36 antibodies: antibody evaluations by CD36‐transfected cell lines

Lin

Lee

et al. 2017

Transfusion

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BACKGROUND: Isoantibodies against CD36 (platelet glycoprotein 4), developed in Type I CD36-deficient mothers are frequently reported as the cause of fetal/ neonatal alloimmune thrombocytopenia in the Asian population. Therefore, further detailed characterization of anti-CD36-mediated fetal/neonatal alloimmune thrombocytopenia is warranted. Here, we report the characterization of a patient with fetal/neonatal alloimmune thrombocytopenia in a Taiwanese family caused by anti-CD36 isoantibodies using a novel antigen-capture method. STUDY DESIGN AND METHODS:Platelets and monocytes were analyzed for CD36 expression by flow cytometry. Sequencing analysis of the CD36 gene was performed to identify the mutation underlying the CD36 deficiency. Stable transfected human embryonic kidney HEK293 cells expressing recombinant CD36 were established. These cells were used for the characterization of anti-CD36 isoantibodies by flow cytometry, immunoprecipitation, and antigen-capture assay. RESULTS:Flow cytometry analysis revealed a total absence of CD36 on both platelets and monocytes of the mother (Type I CD36-deficient) caused by heterozygous deletions of the CD36 gene (332_333delCA and c.1254 1 6_1254 1 11delTATTTG). Analysis of maternal serum with CD36-transfected HEK293 cells by flow cytometry, immunoprecipitation, and antigen-capture assay demonstrated the presence of anti-CD36 isoantibodies in maternal serum. Interestingly, this antibody could not be detected by the monoclonal antibody immobilization of platelet antigens assay when anti-CD36 monoclonal antibody (clone FA6-152) was used as the capture antibody.CONCLUSION: This case reemphasizes the role of anti-CD36 isoantibodies on the pathomechanism of fetal/ neonatal alloimmune thrombocytopenia. The fact that the monoclonal antibody immobilization of platelet antigens assay does not seem to be reliable for the identification of all anti-CD36 antibodies indicates that screening of anti-CD36 isoantibodies by a monoclonal antibody-independent method, as presented here, should be considered. Fetal/neonatal alloimmune thrombocytopenia (FNAIT), which occurs in from 1 of 800 to 1 of 1000 live births, is the most common cause of severe thrombocytopenia and intracranial hemorrhage in the fetus and in term newborns.1,2 FNAIT is caused by maternal antibodies, which recognize paternalderived alloantigens on fetal platelets, leading to platelet destruction. In Caucasians, more than 75% of FNAIT cases are induced by alloantibodies against human platelet antigen-1a (HPA-1a), 3,4 whereas the most common antibodies causing FNAIT in Japanese are anti-HPA-4b alloantibodies. The clinical importance of anti-CD36 isoantibodies in the development of FNAIT has been reported in different populations.9-13 Currently, the antigen-capture assay represents the gold standard for detecting platelet antibodies. 14 With this assay, platelet antigens captured by mouse monoclonal antibody are used as the target for platelet antibodies. Unfortunately, this approach does not seem to be reliable for the identi...

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“…The volume of blood loss is related to peripheral cytopenias. A small volume of blood loss does not lead to peripheral cytopenias, whereas a large volume of blood loss may result in peripheral cytopenias, in addition to severe anemia [50]. Patients with portal hypertension are often complicated by gastrointestinal bleeding, thus leading to cytopenias [51].…”

Section: Blood Lossmentioning

confidence: 99%

Non-Hypersplenism Causes of Peripheral Cytopenias in Patients with Cirrhotic Portal Hypertension: A Review

Lv¹,

Lau²,

Deng³

et al. 2016

J Hypertens (Los Angel)

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Hypersplenism and non-hypersplenism factors, either alone or in combination, can cause peripheral cytopenias in patients with cirrhotic portal hypertension. Although non-hypersplenism factors account for only a small proportion of patients, they do exist. When peripheral cytopenias do not improve, or fail to improve adquately, or even become worse after splenectomy in these patients, non-hypersplenism factors should be considered. This review aims to provide an overview of non-hypersplenism factors.

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Neonatal alloimmune thrombocytopeniadue to anti‐Nak^a

Abstract: These findings suggested a diagnosis of NAIT caused by anti-Nak(a).

Cited by 31 publications

References 15 publications

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody

Fetal/neonatal alloimmune thrombocytopenia due to anti‐CD36 antibodies: antibody evaluations by CD36‐transfected cell lines

Non-Hypersplenism Causes of Peripheral Cytopenias in Patients with Cirrhotic Portal Hypertension: A Review

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Neonatal alloimmune thrombocytopeniadue to anti‐Naka

Abstract: These findings suggested a diagnosis of NAIT caused by anti-Nak(a).

Cited by 31 publications

References 15 publications

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Naka) isoantibody

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Naka) isoantibody

Fetal/neonatal alloimmune thrombocytopenia due to anti‐CD36 antibodies: antibody evaluations by CD36‐transfected cell lines

Non-Hypersplenism Causes of Peripheral Cytopenias in Patients with Cirrhotic Portal Hypertension: A Review

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Neonatal alloimmune thrombocytopeniadue to anti‐Nak^a

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody

Life‐threatening adverse reaction followed by thrombocytopenia after passive transfusion of fresh frozen plasma containing anti‐CD36 (Nak^a) isoantibody