Risk factors for severe neonatal thrombocytopenia in cases of maternal immune thrombocytopenia

Point, Florian; Terriou, Louis; Rakza, Thameur; Drumez, Élodie; Alluin, Gauthier; Garabédian, Charles; Véronique, Houfflin‐Debarge

doi:10.1111/apa.16252

Cited by 6 publications

(8 citation statements)

References 27 publications

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“…The risk of the child being born thrombocytopenic or developing thrombocytopenia after delivery is higher when the mother has had a splenectomy (splenectomy does not remove platelet autoantibodies, only the site of platelet degradation) or had to be treated for low platelet counts during her pregnancy. Also, if neonatal thrombocytopenia occurred in a previous pregnancy, the risk is increased [134].…”

Section: Diagnostic Workupmentioning

confidence: 99%

Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment – Recommendations from an Expert Group from Austria, Germany, and Switzerland

Matzdorff¹,

Alesci²,

Gebhart³

et al. 2023

Oncol Res Treat

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Section: Diagnostic Workupmentioning

confidence: 99%

Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment – Recommendations from an Expert Group from Austria, Germany, and Switzerland

Matzdorff¹,

Alesci²,

Gebhart³

et al. 2023

Oncol Res Treat

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“…With the increased risk of ICH in severe NAIT, recognition of signs and symptoms is followed promptly by treatment with a platelet infusion that is HPA-1a and 5b negative, steroids, IVIG, or a combination of these three treatments. Treatment for severe NAIT usually begins with platelet transfusion of HPA-1a and 5b negative plasma the first-line treatment of choice and is then escalated to IVIG therapy where available [ 1 , 8 ]. Treatment is aimed at limiting the risk of negative outcomes such as hydrocephalus, gastrointestinal hemorrhage, or even death.…”

Section: Discussionmentioning

confidence: 99%

“…The patient’s mother received routine and adequate prenatal care throughout her pregnancy. The mother does not have a history of immune thrombocytopenia, which could have been a risk factor in this pregnancy [ 8 ]. There were no anomalies noted on prenatal scans and prenatal labs were all normal.…”

Section: Case Presentationmentioning

confidence: 99%

“…Treatments that are currently available and have been shown to be effective are steroids given after birth in mild cases with platelet transfusions of platelets that are HPA-1a and 5b negative and intravenous immune globulin (IVIG) used in cases of severe disease or in cases of persistent hemorrhage [ 7 ]. If there is a history of maternal immune thrombocytopenia (ITP), splenectomy, or previous pregnancy that resulted in NAIT, precautions, such as a complete blood count (CBC) at the time of birth to rule out thrombocytopenia, should be taken at the time of delivery to provide quick testing and diagnosis of a newborn with NAIT so treatment will not be delayed [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Severe Neonatal Alloimmune Thrombocytopenia in a Multiparous Female With No Prior History

Judd¹,

Tomsic²

2022

Cureus

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Neonatal Alloimmune Thrombocytopenia (NAIT) is the most common cause of severe thrombocytopenia in newborns. It is also the most common cause of morbidity and mortality in full-term infants that present with severe thrombocytopenia, given its association with intracranial hemorrhage (ICH). NAIT can present in many ways depending on the severity of platelet destruction. The patient's presentation can range from asymptomatic or can include more serious symptoms such as petechial rash and ICH. Due to potentially fatal outcomes of undiagnosed severe NAIT, it is imperative that patients are identified, diagnosed, and treated in a timely and efficient manner. We report a case of NAIT in a newborn male infant who initially was asymptomatic and eventually developed a petechial rash that encompassed the torso and groin as the only signs of disease. Given the importance of the timely diagnosis and treatment of NAIT and its potentially fatal outcomes, the aim of this case report is to help clinicians recognize the presentation of NAIT and the steps in treating it.

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“…2 However, maternal immune thrombocytopenia (ITP) can lead to neonatal thrombocytopenia, posing a risk of neonatal hemorrhagic complications and requiring careful management and treatment of the mother and newborn. 1,3…”

mentioning

confidence: 99%

A case of neonatal thrombocytopenia due to maternal Helicobacter pylori‐associated immune thrombocytopenia

et al. 2023

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Many studies in adults have suggested an association between Helicobacter pylori (H. pylori) infection and chronic immune thrombocytopenia (ITP). In adults with ITP and H. pylori infection, eradicating H. pylori is recommended as the first‐line therapy. However, the association between ITP and H. pylori in children remains controversial. Diagnosing thrombocytopenia in pregnant women is challenging but crucial because maternal ITP causes neonatal ITP through transplacental transfer of immunoglobulin G, also known as passive ITP. Herein, we report a case of neonatal passive ITP due to maternal H. pylori‐associated ITP. A boy was born at term with neonatal thrombocytopenia to a mother tentatively diagnosed with gestational thrombocytopenia. However, further examination suggested that maternal thrombocytopenia was associated with H. pylori, and neonatal thrombocytopenia was diagnosed as ITP due to maternal ITP. The newborn received intravenous immunoglobulin treatment, and the thrombocytopenia did not recur. The mother was examined using esophagogastroduodenoscopy, and her rapid urease test using gastric mucosa tissue samples was positive. Subsequently, she was diagnosed with H. pylori infection and received H. pylori eradication therapy, after which her platelet count remained normal. To our knowledge, this is the first reported case of neonatal passive ITP secondary to maternal H. pylori‐associated ITP. This case suggests that maternal H. pylori infection can lead to the production of platelet autoantibodies, which can destroy antibody‐sensitized platelets in the mother and neonate. To summarize, H. pylori infection can also cause ITP in children. Therefore, pregnant women diagnosed with H. pylori‐associated ITP should receive H. pylori eradication therapy to prevent their neonates from developing passive ITP.

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Risk factors for severe neonatal thrombocytopenia in cases of maternal immune thrombocytopenia

Cited by 6 publications

References 27 publications

Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment – Recommendations from an Expert Group from Austria, Germany, and Switzerland

Expert Report on Immune Thrombocytopenia: Current Diagnostics and Treatment – Recommendations from an Expert Group from Austria, Germany, and Switzerland

Severe Neonatal Alloimmune Thrombocytopenia in a Multiparous Female With No Prior History

A case of neonatal thrombocytopenia due to maternal Helicobacter pylori‐associated immune thrombocytopenia

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