Faculty Collaboration Database

Neonatal neutropenia and bacterial sepsis associated with placental transfer of maternal neutrophil-specific autoantibodies. Transfusion 2004 Jul;44(7):1041-6

Date

07/01/2004

Pubmed ID

15225245

DOI

10.1111/j.1537-2995.2004.03410.x

Scopus ID

2-s2.0-3042590770 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND: Passively acquired neonatal neutropenia is an infrequently reported complication of maternal autoimmune neutropenia (AIN). Two affected siblings are described. The firstborn developed Citrobacter meningitis and was permanently disabled. The second was success-fully managed with pre- and postnatal injections of recombinant human granulocyte colony-stimulating factor (rHuG-CSF).

STUDY DESIGN AND METHODS: Neutrophil-specific antibodies were evaluated by flow cytometry (FC), monoclonal antibody immobilization of granulocyte antigens, and granulocyte agglutination assays.

RESULTS: A neutrophil-reactive antibody was detected by FC in samples of the mother's serum spanning a 4-year time frame. This antibody reacted with neutrophils from the mother, father, and their first infant and with 18 of 20 target neutrophils tested. In serologic studies, it was shown that the antibody was not specific for the commonly recognized neutrophil-specific alloantigens HNA-1a (NA1), HNA-1b (NA2), HNA-1c (SH), HNA-2a (NB1), or HNA-3a (5b).

CONCLUSION: Severe neonatal neutropenia in the two siblings appears to have been caused by placental transfer of a maternal neutrophil-reactive autoantibody of undetermined specificity. Neutrophil counts should be evaluated in infants born to mothers with chronic neutropenia of possible autoimmune origin so that neutropenic infants can be carefully monitored and antibiotics and/or rHuG-CSF administered if indicated.

Author List

Davoren A, Saving K, McFarland JG, Aster RH, Curtis BR

Author

Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Autoantibodies
Bacteremia
Female
Granulocyte Colony-Stimulating Factor
Humans
Infant, Newborn
Maternal-Fetal Exchange
Neutropenia
Neutrophils
Placenta
Pregnancy
Recombinant Proteins