1/13. Neonatal alloimmune neutropenia in premature monozygous twins.Alloimmune neonatal neutropenia (ANN) is an uncommon but potentially life-threatening disorder of the neonate and young infant. Hematologically, the mother's peripheral neutrophil count is normal. However, the passive transfer of maternal immunoglobulin g neutrophil-specific antibodies and the subsequent sensitization of fetal neutrophils can result in severe neutropenia in the neonate. Generally, ANN is a self-limiting condition, but with severe bacterial infection, mortality can be high. We present the clinical features of monozygous twins delivered at 33 weeks' postconception with this condition. This case report is unique in that it occurred in twins born prematurely and was attributable to antibodies against 2 neutrophil-specific antigens, NA1 and NB1. A brief review of the diagnosis, management, and treatment of ANN is presented.- - - - - - - - - - ranking = 1keywords = alloimmune (Clic here for more details about this article) |
2/13. Treatment of severe thrombocytopenia in alloimmunized, transfusion-refractory patients.A significant proportion of patients with hematologic malignancies who are exposed to multiple transfusions will develop alloantibodies to platelet human leukocyte antigens (HLA), resulting in poor responses to subsequent platelet transfusions. Transfusion of HLA-identical platelets is an effective method of platelet support in these patients, but perfectly HLA-matched platelets are often not available. In this paper, we review the recent literature on platelet transfusion support in alloimmunized individuals and illustrate alternative management strategies with cases from our own practice.- - - - - - - - - - ranking = 0.021174977489234keywords = thrombocytopenia (Clic here for more details about this article) |
3/13. A case of antenatal cerebral haemorrhage resulting from maternal alloimmunisation against fetal platelets.Prenatal thrombocytopenia is a rare event and is generally due to fetal infection. In very rare cases, fetal thrombocytopenia is induced by maternal IgG directed against the fetal platelets. This alloimmunisation could lead to in utero bleeding. We now report such a case, in which fetal thrombocytopenia was complicated by a huge temporal lobe haematoma. Such a prenatal event is rare: only eight cases have been published, with only one pathologically confirmed case. Our patient is the second one in which neuropathological examination demonstrated prenatal intracerebral bleeding.- - - - - - - - - - ranking = 0.015881233116925keywords = thrombocytopenia (Clic here for more details about this article) |
4/13. Immune hemolysis involving non-ABO/RhD alloantibodies following hematopoietic stem cell transplantation.We report two cases of severe alloimmune hemolysis after hematopoietic stem cell (HSC) transplant resulting from an anti-Jk(a). The time course of hemolysis and Jk phenotypes of the donor and recipient in the cases reported suggest that the antibody was produced by donor-derived passenger lymphocytes. Retrospective analysis of the blood bank records of all allogeneic HSC transplant patients at Barnes-Jewish Hospital from 1994 to 1999 suggests that the incidence of alloimmune hemolysis due to incompatibilities involving non-ABO or RhD red cell antigens is very low, approximately 1%. In one patient, the duration of hemolysis was shortened significantly by performing red cell exchange at the first sign of intravascular hemolysis.- - - - - - - - - - ranking = 0.5keywords = alloimmune (Clic here for more details about this article) |
5/13. Fetal anemia as a response to prophylactic platelet transfusion in the management of alloimmune thrombocytopenia.The antenatal management of alloimmune thrombocytopenia (ATP) frequently requires fetal blood sampling and prophylactic platelet transfusion. A recent case of ATP complicated by associated red blood cell alloimmunization demonstrated severe hemolysis apparently as a result of ABO incompatibility from transfused platelets.- - - - - - - - - - ranking = 2.7460653647481keywords = alloimmune thrombocytopenia, alloimmune, thrombocytopenia (Clic here for more details about this article) |
6/13. Fetomaternal alloimmune thrombocytopenia presenting as intracerebral bleeding in utero.Feto-maternal alloimmune thrombocytopenia is a serious fetal disorder resulting from platelet antigen incompatibility between the mother and the fetus. Intracranial bleeding is the most serious complication of alloimmune thrombocytopenia and can result in severe disability and death in utero. The authors report a case of intracerebral hemorrhage in utero resulting from alloimmune thrombocytopenia.- - - - - - - - - - ranking = 3.8444915106473keywords = alloimmune thrombocytopenia, alloimmune, thrombocytopenia (Clic here for more details about this article) |
7/13. Transient thrombocytopenia after incompatible red blood transfusion in an infant girl with autoimmune hemolytic anemia.We report on 5-month-old girl with severe autoimmune hemolytic anemia (hemoglobin 2.9 g/dl, positive direct coombs test) in whom thrombocytopenia developed after red blood cell transfusion. The platelet count was 62.1 x 10(4)/mm3 on admission and rapidly fell to 6.0 x 10(4)/mm3 rapidly after transfusion of incompatible red blood cells with intravenous predonisolone administration. No increased hemolysis or alloimmunization was observed after transfusion. The platelet count and hemoglobin levels gradually improved over 8 weeks with corticosteroid therapy. We suspect that the thrombocytopenia in our patient was transfusion-induced.- - - - - - - - - - ranking = 0.031762466233851keywords = thrombocytopenia (Clic here for more details about this article) |
8/13. Neonatal alloimmune thrombocytopenia due to fetomaternal Zwb incompatibility.A case of neonatal alloimmune thrombocytopenia due to fetomaternal incompatibility against the platelet-specific antigen Zwb (PlA2) is described. The antibody was of the IgG class and did not fix complement in vitro. Its specificity was established by panel identification and by comparison to a Zwb antiserum. gene dosage determinations of Zwa antigens on platelets of parents and child revealed that the mother was homozygous Zwa Zwa, while father and child were heterozygous for this antigen.- - - - - - - - - - ranking = 3.5917463414156keywords = neonatal alloimmune, neonatal alloimmune thrombocytopenia, alloimmune thrombocytopenia, alloimmune, thrombocytopenia (Clic here for more details about this article) |
9/13. Post-transfusion purpura associated with alloimmunization against the platelet-specific antigen, Baka.Post-transfusion purpura (PTP) with severe thrombocytopenia occurred eight days after transfusion in a 28-year-old woman and responded to treatment with prednisone and plasma exchange. In contrast to nearly all previously studied cases of PTP, the patient's platelets were PlA1-positive and anti-PlA1 antibody could not be detected in serum obtained during the thrombocytopenic episode. Her serum was found to contain an antibody specific for a recently described platelet-specific alloantigen, Baka, in addition to multiple HLA-specific antibodies. The patient's platelets, typed following recovery, were Baka-negative. These findings indicate that post-transfusion purpura can occur in association with alloimmunization to platelet-specific antigens other than PlA1. In performing the serologic studies, a close relationship and possible identity between Baka and another recently reported platelet antigen, Leka, was observed. A method for analyzing mixtures of cytotoxic platelet-reactive antibodies without separating the individual antibodies is described.- - - - - - - - - - ranking = 0.0052937443723085keywords = thrombocytopenia (Clic here for more details about this article) |
10/13. The treatment of neonatal isoimmune thrombocytopenia with intravenous immunoglobin (IgG i.v.).We present a report of the use of IgG i.v. to treat clinically manifest neonatal immune thrombocytopenia. The IgG i.v. was administered at a daily dosage of 0.4 g/kg body weight for 5 days. Treatment was started when the child was 3 days old and had a platelet count of 2 X 10(9)/l. Four days later the platelet count had risen to 200 X 10(9)/l. The diagnosis of immune thrombocytopenia was confirmed by platelet typing of the mother's and child's platelets and identification of anti-platelet antibodies in maternal serum.- - - - - - - - - - ranking = 0.031762466233851keywords = thrombocytopenia (Clic here for more details about this article) |
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