Neonatal alloimmune thrombocytopenia
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: NAITP; NAIT; NAT; feto-maternal alloimmune thrombocytopenia ; FMAITP; FMAIT
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Neonatal Alloimmune Thrombocytopenia is a disease that affects fetuses and newborns. Genetic differences between the fetus and mother may result in the expression of certain antigens by fetal platelets, not expressed by the mother. Fetomaternal transfusions result in the recognition of these antigens by the mother’s immune system as non-self, with the subsequence generation of allo-reactive antibodies which cross the placenta. NAIT, hence, is caused by transplacental passage of maternal platelet-specific alloantibody and rarely human leukocyte antigen (HLA) allo-antibodies (which are expressed by platelets) to fetuses whose platelets express the corresponding antigens.
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Historical Perspective
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Classification
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Pathophysiology
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Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
About 80% of cases of NAIT are caused by antibodies against platelet antigen HP-1a, 15% by anti-HP-5a, and 5% by other antibodies. Unlike the hemolytic disease, NAIT occurs during the first pregnancy in to 50% of cases, and the affected fetuses may develop severe thrombocytopenia (<50,000 /μL) very early during pregnancy. Usually, the thrombocytopenia increases as gestation progresses.
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Differentiating Neonatal alloimmune thrombocytopenia from other Diseases
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Epidemiology and Demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Epidemiology and Demographics
NAIT occurs in somewhere between 1/800 [1] and 1/5000 [2] live births (more recent studies of NAIT seem to indicate that it occurs in somewhere between 1/800 and 1/1000 live births).
References
- ↑ Doctor Cecil Kaplan (2003-11-01). “Fetal and Neonatal Alloimmune Thrombocytopenia” (PDF). Orphanet Encyclopedia. Retrieved 2007-09-23.
- ↑ Janice G. McFarland, Richard H. Aster, James E. Bussel, John G. Gianopoulos, Rebecca S. Derbes, and Peter J. Newman (1991-11-01). “Prenatal Diagnosis of Neonatal Alloimmune Thrombocytopenia Using Allele-Specific Oligonucleotide Probes”. Blood Journal. Retrieved 2007-09-23.
Risk Factors
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Screening
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Natural History, Complications and Prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History, Complications and Prognosis
In utero intracranial hemorrhage occurs in about 10% of affected cases. This complication may also take place before 20 weeks of gestation. The recurrence of NAIT been estimated to be more than 80% in subsequent pregnancies with incompatible fetuses.
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Diagnosis
Diagnosis
History and Symptoms | Physical Examination |Laboratory Findings | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
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