Perinatal management of neonatal alloimmune thrombocytopenia associated with anti-group A antibody.
Perinatal management of neonatal alloimmune thrombocytopenia associated with anti-group A antibody.
复制标题
与抗 A 组抗体相关的新生儿同种免疫性血小板减少症的围产期管理。
DOI：
10.1111/tme.12178
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Saitoh S.
中科院分区：
文献类型：
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作者：
Ueda H;Sugiura T;Katano K;Matsuhashi M;Kato S;Ito K;Nagasaki R;Kato T;Tsuno NH;Saitoh S.
目的对新生儿抗A组抗体所致的同种免疫性血小板减少症进行围产期管理。我们之前报道了一例严重颅内出血与新生儿同种免疫血小板减少症相关的病例，这是由于抗a组同种抗体引起的。材料/方法一名40岁的日本妇女，妊娠4期1，怀第二胎。前一个兄弟姐妹出现了严重的血小板减少症，并在出生后10天因颅内出血而死亡。他被诊断为新生儿同种免疫性血小板减少症；致病抗体为抗A组抗体。强的松在妊娠7周时开始使用。29周开始静脉注射免疫球蛋白1g kg - 1week - 1，并继续分娩。进行血清学研究和基因分型。结果第二例男婴在33周孕龄时经剖宫产。出院时无颅内出血或血小板减少症。母体血清抗A组抗体滴度为2048 ~ 4096（正常范围：4 ~ 64）。新生儿血清抗A组抗体滴度为4。母亲血清和父亲血小板交叉匹配呈阳性。结论由于有新生儿同种免疫性血小板减少症导致颅内出血和前一个兄弟姐妹死亡的病史，因此对后续妊娠进行了严格的随访。
ObjectiveTo prevent neonatal alloimmune thrombocytopenia due to anti‐group A antibody perinatal management was performed.BackgroundWe previously reported a case of severe intracranial haemorrhage associated with neonatal alloimmune thrombocytopenia due to anti‐group A isoantibody.Material/MethodsA 40‐year‐old Japanese woman, gravida 4 para 1, was pregnant with her second baby. The previous sibling developed severe thrombocytopenia and died 10 days after birth due to intracranial haemorrhage. He was diagnosed with neonatal alloimmune thrombocytopenia; the causative antibody was found to be the anti‐group A antibody. Prednisone was started at 7 weeks' gestational age. Intravenous immunoglobulin 1 g kg−1week−1was started at 29 weeks' gestational age and continued to delivery. Serological studies and genotyping were performed.ResultsThe second boy was delivered at 33 weeks' gestational age by caesarean section. He was discharged without intracranial haemorrhage or thrombocytopenia. The anti‐group A antibody titre in the maternal serum was 2048–4096 (normal range: 4–64). The anti‐group A antibody titre in the newborn's serum was 4. Cross‐matching between the maternal serum and the paternal platelets was positive.ConclusionOwing to the history of neonatal alloimmune thrombocytopenia causing intracranial haemorrhage and death of the previous sibling, strict follow‐up of the subsequent pregnancy was conducted.