Fetal and neonatal alloimmune thrombocytopenia.

Abstract

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is an alloimmune disorder resulting from platelet opsonization by maternal antibodies that destroy fetal platelets. The major risk of FNAIT is severe bleeding, particularly intracranial hemorrhage. Miscarriage has also been reported but the incidence requires further study. Analogous to adult autoimmune thrombocytopenia (ITP), the major target antigen in FNAIT is the platelet membrane glycoprotein (GP)IIbIIIa. FNAIT caused by antibodies against platelet GPIbα or other antigens has also been reported, but the reported incidence of the anti-GPIbα-mediated FNAIT is far lower than in ITP. To date, the maternal immune response to fetal platelet antigens is still not well understood and it is unclear why bleeding is more severe in FNAIT than in ITP. In this review, we introduce the pathogenesis of FNAIT, particularly those new discoveries from animal models, and discuss possible improvements for the diagnosis, therapy, and prevention of this devastating disease.

• Authors: Darko Zdravic, Issaka Yougbare, Brian Vadasz, Conglei Li, Alexandra H Marshall, Pingguo Chen, Jens Kjeldsen-Kragh, Heyu Ni
• Journal: Seminars in fetal & neonatal medicine (Semin Fetal Neonatal Med) Vol. 21 Issue 1 Pg. 19-27 (Feb 2016) ISSN: 1878-0946 [Electronic] Netherlands
• PMID: 26810319 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.

Topics

• Animals
• Disease Models, Animal
• Female
• Humans
• Infant, Newborn
• Perinatal Care (methods)
• Pregnancy
• Prenatal Diagnosis
• Thrombocytopenia, Neonatal Alloimmune (diagnosis, etiology, immunology, therapy)