Neonatal alloimmune thrombocytopenia associated with maternal-fetal incompatibility for blood group B. Transfusion 2008 Feb;48(2):358-64
Date
11/22/2007Pubmed ID
18028270Pubmed Central ID
PMC3572505DOI
10.1111/j.1537-2995.2007.01531.xScopus ID
2-s2.0-38349149500 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
BACKGROUND: Blood group A and B antigens are expressed only weakly on platelets (PLTs) of most individuals but are very strongly expressed on PLTs from approximately 1 percent of normal subjects (Type II high expressers). The implications of this trait for transfusion medicine are undefined.
STUDY DESIGN AND METHODS: A family was studied in which two Group B infants were born with neonatal thrombocytopenia, whereas a third infant whose blood group was A(2) had a normal PLT count at birth.
RESULTS: Serologic studies demonstrated a maternal antibody that reacted strongly with PLTs from the father and the two group B children in flow cytometry and with GPIIb/IIIa from their PLTs in solid-phase assays. No PLT-specific antibodies were detected in maternal serum sample, but it contained a high-titer immunoglobulin G antibody specific for blood group B. All PLT-reactive antibody in the mother's serum was removed by absorption with pooled, washed group A and B red cells (RBCs). Studies with monoclonal anti-B and measurement of serum B-glycosyltransferase activity showed that the father and both group B children were Type II high expressers of blood group B.
CONCLUSIONS: The findings indicate that high-titer blood group antibodies acquired from the mother can cause thrombocytopenia in infants possessing the Type II high-expresser phenotype despite competition for antibody binding by blood group antigens expressed on RBCs and other tissues.
Author List
Curtis BR, Fick A, Lochowicz AJ, McFarland JG, Ball RH, Peterson J, Aster RHAuthor
Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of WisconsinMESH terms used to index this publication - Major topics in bold
ABO Blood-Group SystemAntibodies
Blood Group Incompatibility
Child
Fathers
Female
Humans
Infant, Newborn
Isoantigens
Male
Maternal-Fetal Exchange
Platelet Glycoprotein GPIIb-IIIa Complex
Pregnancy
Sensitivity and Specificity
Thrombocytopenia, Neonatal Alloimmune
