Neonatal Neutropenia Due to Maternal Isoimmunization

Abstract

A family is reported with multiple cases of neonatal neutropenia. The first child died of severe infection, the second was asymptomatic, the third and the fourth children had a benign course of agranulocytosis which lasted about 10 weeks and was followed by spontaneous recovery. A potent leukoagglutinin was found in the maternal serum which agglutinated leukocytes obtained from the father and all three available children but failed to agglutinate the mother’s own cells. Identical leukoagglutinin was found in the last baby’s serum; it disappeared after the baby recovered. The disorder is tentatively named "isoimmune neonatal neutropenia" and is considered to represent a condition analogous to erythroblastosis fetalis.

Identification of a Specific Leukocyte Antigen: Another Presumed Example of 5b

“…Concurrently we have explored the distribution of another antigen which was involved in the Occurrence of neonatal neutropenia. 12 In contrast to "Ke." this antigen was found exclusively in neutrophilic granulocytes.…”

Detection of antineutrophil autoantibodies by flow cytometry: Use of unfixed neutrophils as antigenic targets

“…Thus the use of random donors as sources of target neutrophils introduces the potential for false negative results due to absence of specific allelic antigens on target neutrophils. Particularly in neonatal alloimmune neutropenia, phenotypic heterogeneity of target neutrophils may significantly influence the detection of antineutrophil antibodies (2,3,(18)(19)(20)(21). However, in our studies of adults with neutropenia, this has not been the case.…”

“…Numerous assays have been developed to detect antineutrophil antibodies, including the leukocyte agglutination technique (3,4), neutrophil opsonization (5,6), indirect granulocyte immunofluorescence using fluorescence microscopy (7), quantitative antiglobulin consumption (8) ~ radiolabeled antiglobulin binding (9), and staphylococcal protein A binding (10). These methods, however, can be time-consuming, tedious, difficult to quantitate.…”

Cytotoxic HL‐A Antibodies: Immunoglobulin Classification

“…T h e EDTA leukoagglutination, and to some extent other agglutination methods, reveal a number of antigenic systems sprcific for polymorphonuclear leukocytes, for example the 5a/5b (Lawler & Shatwell 1967), 9a/9b (van Rood et a]. 1967) and the systems described by Lalezari et al (1960Lalezari et al ( , 1970 in addition to the HL--A antigens.…”