Case report
Diagnosis of fetal and neonatal alloimune thrombocytopenia and successful therapy with intravenous immunoglobulin
Miljenka Lemac
; Department of Obstetrics and Gynecology, Clinical Hospital Centre “Sveti Duh”
Berivoj Mišković
; Department of Obstetrics and Gynecology, Clinical Hospital Centre “Sveti Duh”
Abstract
We present a case of fetal and neonatal alloimmune thrombocytopenia (FNAT) in secundipara woman. In her first pregnancy, she delivered a newborn with a heavy form of neonatal autoimmune thrombocytopenia. The diagnosis was confirmed by the evidence of anti HPA-1a antibodies in HPA-1a negative mother and a positive homozygous HPA-1a father. The newborn was treated with platelet transfusions (PT) and corticosteroid therapy because of a developed widespread skin petechiae and markedly low platelet count (19 × 109). According to the outcome of the first pregnancy in the index pregnancy the therapeutic regime consisted of a weekly administration of intravenous immunoglobulin (IVIG) in 1mg/kg of mother weight dose from week 20 until week 36. There were no maternal or fetal complications throughout pregnancy and a vital, female newborn 3720 g. was delivered by elective Caesarean section in the 37 weeks of gestation. The newborn had no clinical signs of FNAT, and there was normal platelet count of 146 × 109/L and negative test for antithrombocytic IgG antibodies in umbilical cord blood. We concluded that the therapy regime was optimal because of the lack of clinical signs of disease as well as normal laboratory findings. Due to low incidence and specifi c antenatal diagnostic protocol and treatment, it is recommended to present and collect cases of FNAT.
Keywords
fetal and neonatal alloimmune thrombocytopenia; antithrombocytic antibodies; HPA-1a; intravenous immunoglobulins
Hrčak ID:
251771
URI
Publication date:
1.7.2017.
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