Severe intracranial haemorrhage in neonatal alloimmune thrombocytopenia

Silva, Francisco; Morais, Sofia; Sevivas, Teresa; Veiga, Ricardo; Salvado, Ramón; Taborda, Adelaide

doi:10.1136/bcr.07.2011.4563

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…In people of mixed European descent, 80% to 90% of cases are due to antibodies targeting HPA-1a on β3. Severe bleeding is a hallmark of FNAIT, particularly intracranial hemorrhage (ICH), which can occur in fetuses as early as the 14th week of pregnancy and in 10% to 20% of neonates and can lead to neurological impairment or death in both fetuses and neonates (8)(9)(10). The pathogenic mechanism leading to the devastating ICH has, however, never been adequately explored.…”

Section: Introductionmentioning

confidence: 99%

Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage

Yougbaré¹,

Lang²,

Hong³

et al. 2015

J. Clin. Invest.

100

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Section: Introductionmentioning

confidence: 99%

Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage

Yougbaré¹,

Lang²,

Hong³

et al. 2015

J. Clin. Invest.

100

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“…We speculate that subclinical haemorrhage could explain some cases of fetal VM and could precede devastating ICH causing further neurological sequelae. Indeed, ICH is the most severe clinical complication of FNAIT [18,[47][48][49] that can also occur early in utero suggesting that early diagnosis and management are necessary to decrease morbidity and mortality [21,50,51] . The diagnosis of alloimmunisation should be considered after excluding other causes of fetal VM.…”

Section: Discussionmentioning

confidence: 99%

Association between Fetal Cerebral Ventriculomegaly and Platelet Alloimmunisation

Martillotti

Rypens²,

David³

et al. 2016

Fetal Diagn Ther

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Introduction: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare condition that may lead to intracerebral haemorrhage (ICH) in the fetus or neonate. Platelet alloimmunisation causing FNAIT has been described in association with fetal cerebral ventriculomegaly (VM), presumably due to subclinical ICH. The objective of this study was to assess the association between fetal VM and platelet alloimmunisation. Methods: This is a case series of pregnancies with fetal VM screened for platelet alloantibodies from 2003 to 2012. Cases of multiple pregnancies, structural anomalies, aneuploidies, or congenital infection were excluded. Results: Of 45 pregnancies with fetal VM that were screened for platelet alloantibodies, 5 (11%) were positive. There was only one antenatal ICH, with confirmed fetal severe thrombocytopenia before termination of pregnancy. The other cases were treated with intravenous immunoglobulins without prior fetal blood sampling. No other case of neonatal thrombocytopenia was confirmed. Conclusions: The prevalence of platelet alloimmunisation was high in this series of fetal VM. Prospective large studies are needed to confirm the role of platelet alloimmunisation in fetal VM.

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“…95,108–110 ICH occurs at a rate of 10%–20% in neonates born with FNAIT and has fatal consequences in approximately 5% of documented cases. 102,111 An ICH can also occur in utero as early as week 14 of pregnancy in fetuses affected by FNAIT, 112 suggesting that early diagnosis and management are necessary to prevent morbidity and mortality.…”

Section: Fetal and Neonatal Alloimmune Thrombocytopeniamentioning

confidence: 99%

“…FNAIT is also the most common cause of intracranial hemorrhage (ICH) in full-term infants, 107 which is the most severe clinical complication of FNAIT and may lead to neurological impairments or death. 95 , 108 , 109 , 110 ICH occurs at a rate of 10%–20% in neonates born with FNAIT and has fatal consequences in approximately 5% of documented cases. 102 , 111 An ICH can also occur in utero as early as week 14 of pregnancy in fetuses affected by FNAIT, 112 suggesting that early diagnosis and management are necessary to prevent morbidity and mortality.…”

Section: Fetal and Neonatal Alloimmune Thrombocytopeniamentioning

confidence: 99%

Platelets and platelet alloantigens: Lessons from human patients and animal models of fetal and neonatal alloimmune thrombocytopenia

et al. 2015

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Platelets play critical roles in hemostasis and thrombosis. Emerging evidence indicates that they are versatile cells and also involved in many other physiological processes and disease states. Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a life threatening bleeding disorder caused by fetal platelet destruction by maternal alloantibodies developed during pregnancy. Gene polymorphisms cause platelet surface protein incompatibilities between mother and fetus, and ultimately lead to maternal alloimmunization. FNAIT is the most common cause of intracranial hemorrhage in full-term infants and can also lead to intrauterine growth retardation and miscarriage. Proper diagnosis, prevention and treatment of FNAIT is challenging due to insufficient knowledge of the disease and a lack of routine screening as well as its frequent occurrence in first pregnancies. Given the ethical difficulties in performing basic research on human fetuses and neonates, animal models are essential to improve our understanding of the pathogenesis and treatment of FNAIT. The aim of this review is to provide an overview on platelets, hemostasis and thrombocytopenia with a focus on the advancements made in FNAIT by utilizing animal models.

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Severe intracranial haemorrhage in neonatal alloimmune thrombocytopenia

Cited by 12 publications

References 7 publications

Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage

Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage

Association between Fetal Cerebral Ventriculomegaly and Platelet Alloimmunisation

Platelets and platelet alloantigens: Lessons from human patients and animal models of fetal and neonatal alloimmune thrombocytopenia

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