Fetal and neonatal alloimmune thrombocytopenia: review article and retrospective analysis of clinical and laboratory characteristics of patients in Slovenia between 1996 and 2016

  • Jana Lozar Krivec Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Tatjana Tanasič Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Jelena Đorđević Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Petra Fidler Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Maribor, Maribor, Slovenia
  • Irena Štucin Gantar Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Andreja Trojner-Bregar Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  • Primož Rožman Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
  • Polona Klemenc Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
  • Darja Paro-Panjan Neonatal Unit, Division of Paediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
Keywords: , alloimmunisation, thrombocytopenia, neonate, pregnancy, human platelet antigen (HPA)

Abstract

Neonatal alloimmune thrombocytopenia (FNAIT) results from transplacental transmission and binding of alloimmune antibodies on child's platelets antigens which were inherited from the father. Alloimmunization of the mother against platelet antigen can occur during present or previous pregnancies or platelet transfusions. FNAIT is a rare disease whose course can be insignificant or with signs of haemorrhagic diathesis. It's most serious complication is intracranial bleeding, therefore early diagnosis and in the case of indications appropriate treatment is very important. Estimated incidence of FNAIT is 1 in 1000-2000 live births. According to the Slovenia’s national vital statistics data we estimate that there should be between 10 and 20 annually serologically confirmed cases of FNAIT. 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 in average 9 requests for FNAIT diagnostic tests per year and 39 cases of FNAIT were confirmed, resulting in incidence rate of  0,1/1000 live births in Slovenia. We are aware that 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. With this contribution we aim to increase awareness about FNAIT, which can be life-threatening and it’s promptly diagnosis may be very important for the child as well as mother’s following pregnancies.

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Published
2019-04-18
How to Cite
1.
Lozar Krivec J, Tanasič T, Đorđević J, Fidler P, Štucin Gantar I, Trojner-Bregar A, Rožman P, Klemenc P, Paro-Panjan D. Fetal and neonatal alloimmune thrombocytopenia: review article and retrospective analysis of clinical and laboratory characteristics of patients in Slovenia between 1996 and 2016. ZdravVestn [Internet]. 18Apr.2019 [cited 18Jun.2019];88(3-4):125-42. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2657