Neonatal alloimmune thrombocytopenia

Fetal and Neonatal Alloimmune Thrombocytopenia
Fetal and Neonatal Alloimmune Thrombocytopenia
Other names	fetal and neonatal alloimmune thrombocytopenia (FNAIT), feto-maternal alloimmune thrombocytopenia (FMAITP, FMAIT)
Specialty	Pediatrics

Neonatal alloimmune thrombocytopenia (NAITP, NAIT, NATP or NAT) is a disease that affects babies in which the platelet count is decreased because the mother's immune system attacks her fetus' or newborn's platelets. A low platelet count increases the risk of bleeding in the fetus and newborn. If the bleeding occurs in the brain, there may be long-term effects.

Platelet antigens are inherited from both mother and father. NAIT is caused by antibodies specific for platelet antigens inherited from the father but which are absent in the mother.^[1] Fetomaternal transfusions (or fetomaternal hemorrhage) results in the recognition of these antigens by the mother's immune system as non-self, with the subsequent 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^[2] (which are expressed by platelets) to fetuses whose platelets express the corresponding antigens.

NAIT occurs in somewhere between 1/800^[3] and 1/5000^[4] live births. More recent studies of NAIT seem to indicate that it occurs in around 1/600 live births in the Caucasian population.^[5]

^ Roback J, Combs MR, Grossman B, Hillyer C (2008). Technical manual (16th ed.). Bethesda, Md.: American Association of Blood Banks (AABB). ISBN 978-1563952609.
^ Porcelijn L, Van den Akker ES, Oepkes D (August 2008). "Fetal thrombocytopenia". Seminars in Fetal & Neonatal Medicine. 13 (4): 223–30. doi:10.1016/j.siny.2008.02.008. PMID 18400574.
^ Kaplan C (October 2006). "Foetal and neonatal alloimmune thrombocytopaenia". Orphanet Journal of Rare Diseases. 1 (1): 39. doi:10.1186/1750-1172-1-39. PMC 1624806. PMID 17032445.
^ McFarland JG, Aster RH, Bussel JB, Gianopoulos JG, Derbes RS, Newman PJ (November 1991). "Prenatal diagnosis of neonatal alloimmune thrombocytopenia using allele-specific oligonucleotide probes". Blood. 78 (9): 2276–82. doi:10.1182/blood.V78.9.2276.2276. PMID 1932744.
^ Kamphuis MM, Paridaans N, Porcelijn L, De Haas M, Van Der Schoot CE, Brand A, Bonsel GJ, Oepkes D (October 2010). "Screening in pregnancy for fetal or neonatal alloimmune thrombocytopenia: systematic review". BJOG. 117 (11): 1335–43. doi:10.1111/j.1471-0528.2010.02657.x. PMID 20618318. S2CID 124702.

[Roback2008-1] Roback J, Combs MR, Grossman B, Hillyer C (2008). Technical manual (16th ed.). Bethesda, Md.: American Association of Blood Banks (AABB). ISBN 978-1563952609.

[pmid18400574-2] Porcelijn L, Van den Akker ES, Oepkes D (August 2008). "Fetal thrombocytopenia". Seminars in Fetal & Neonatal Medicine. 13 (4): 223–30. doi:10.1016/j.siny.2008.02.008. PMID 18400574.

[3] Kaplan C (October 2006). "Foetal and neonatal alloimmune thrombocytopaenia". Orphanet Journal of Rare Diseases. 1 (1): 39. doi:10.1186/1750-1172-1-39. PMC 1624806. PMID 17032445.

[pmid1932744-4] McFarland JG, Aster RH, Bussel JB, Gianopoulos JG, Derbes RS, Newman PJ (November 1991). "Prenatal diagnosis of neonatal alloimmune thrombocytopenia using allele-specific oligonucleotide probes". Blood. 78 (9): 2276–82. doi:10.1182/blood.V78.9.2276.2276. PMID 1932744.

[pmid20618318-5] Kamphuis MM, Paridaans N, Porcelijn L, De Haas M, Van Der Schoot CE, Brand A, Bonsel GJ, Oepkes D (October 2010). "Screening in pregnancy for fetal or neonatal alloimmune thrombocytopenia: systematic review". BJOG. 117 (11): 1335–43. doi:10.1111/j.1471-0528.2010.02657.x. PMID 20618318. S2CID 124702.

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