Fetal and neonatal alloimmune thrombocytopenia: review article and retrospective analysis of clinical and laboratory characteristics of patients in Slovenia between 1996 and 2016
DOI:
https://doi.org/10.6016/ZdravVestn.2657Keywords:
alloimmunisation, thrombocytopenia, neonate, pregnancy, human platelet antigen (HPA)Abstract
Foetal and neonatal alloimmune thrombocytopenia (FNAIT) results from the transplacental transmission and binding of alloimmune antibodies on the child’s platelet antigens which were inherited from the father. Alloimmunisation of the mother against platelet antigen can occur during present or previous pregnancies or platelet transfusions. FNAIT is a rare disease whose course may be insignificant or may present with signs of haemorrhagic diathesis. Its most serious complication is intracranial bleeding, therefore early diagnosis and, in the case of indications, appropriate treatment are very important. The estimated incidence of FNAIT is 1 in 1,000–2,000 live births. According to the Slovenia’s national vital statistics data, we estimate that there should be between 10 and 20 serologically confirmed cases of FNAIT annually. The incidence of FNAIT in Slovenia is not known. The aim of the present retrospective study was to assess the incidence and aetiology of FNAIT in Slovenia and clinical characteristics of the disease. The results of a retrospective study in which we analysed the results of blood tests for the detection of platelet antibodies in infants or mothers have shown a much lower incidence. In the period from 1996 to 2016, there were on average 9 requests for FNAIT diagnostic tests per year and 39 cases of FNAIT were confirmed, resulting in an incidence rate of 1 in 10,000 live births in Slovenia. We are aware that the obtained incidence may be underestimated due to retrospective analysis of the data; nevertheless, our results confirm our clinical observations that FNAIT is underdiagnosed in our area. In the present article, in addition to the results of a retrospective study on the incidence, aetiology and clinical picture of FNAIT in Slovenia, we review current knowledge of FNAIT. This contribution is aimed at increasing awareness about FNAIT, which can be life-threatening, and its prompt diagnosis may be very important for the child as well as for the mother’s following pregnancies.
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