Low-frequency human platelet antigens as triggers for neonatal alloimmune thrombocytopenia. Transfusion 2014 May;54(5):1286-93
Date
10/17/2013Pubmed ID
24128174Pubmed Central ID
PMC3989475DOI
10.1111/trf.12450Scopus ID
2-s2.0-84900495549 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
BACKGROUND: Twenty-four low-frequency human platelet antigens (LFHPAs) have been implicated as immunogens in neonatal alloimmune thrombocytopenia (NAIT). We performed studies to define more fully how often these antigens trigger maternal immunization leading to NAIT.
STUDY DESIGN AND METHODS: In a Phase 1 study, fathers of selected NAIT cases not resolved by serologic testing but thought to have a high likelihood of NAIT on clinical and serologic grounds were typed for LFHPAs by DNA sequencing. In a Phase 2 study, high-throughput methods were used to type fathers of 1067 consecutive unresolved NAIT cases for LFHPAs. Mothers of 1338 unresolved cases were also typed to assess the prevalence of LFHPAs in a population racially/ethnically similar to the fathers.
RESULTS: In Phase 1, LFHPAs were identified in 16 of 244 fathers (6.55%). In Phase 2, LFPAs were found in only 28 of 1067 fathers (2.62%). LFHPAs were identified in 27 of 1338 maternal samples (2.01%). HPA-9bw was by far the most common LFHPA identified in the populations studied and was the only LFHPA that was significantly more common in fathers than in mothers of affected infants (p = 0.02).
CONCLUSIONS: Maternal immunization against recognized LFHPAs accounts for only a small fraction of the cases of apparent NAIT not resolved by standard serologic testing. Typing of the fathers of such cases for LFHPAs is likely to be rewarding only when a maternal antibody specific for a paternal platelet glycoprotein is demonstrated and/or there is compelling clinical evidence for NAIT.
Author List
Peterson JA, Gitter M, Bougie DW, Pechauer S, Hopp KA, Pietz B, Szabo A, Curtis BR, McFarland J, Aster RHAuthors
Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of WisconsinAniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AllelesAntigens, Human Platelet
Female
High-Throughput Screening Assays
Humans
Male
Polymorphism, Single Nucleotide
Thrombocytopenia, Neonatal Alloimmune
