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Neonatal Alloimmün Trombositopeni

Yıl 2011, Cilt: 9 Sayı: 3, 93 - 96, 01.12.2011

Melike Sezgin Evim Adalet Meral Güneş

Öz

Neonatal Alloimmün Trombositopeni NAT yenidoğan döneminde ağır trombositopeniyeneden olan nadir bir hastalıktır. Anne ve bebek arasındaki trombosit antijenuyumsuzluğu sonucunda annede fetal trombositlere karşı gelişen antikorlar, fetusageçerek intrauterin dönemden itibaren trombositopeniye yol açabilir. Klinik bulgularhafif ya da ağır olabilir. Olguların yaklaşık yarısı ilk gebelikte görülür. İzleyen gebeliklerdegörülme sıklığı artar. Olay antikorların uzaklaşması ile kendini sınırlar. Ancak, gebeliksüresince anne ve fetusun dikkatli ve yakından izlenmesi ve endikasyonu olduğutakdirde tedavinin hemen düzenlenmesi gerekir. Artmış mortalite ve morbiditesinedeniyle erken tanınması, tedavi edilmesi ve ailenin sonraki gebeliklerdeki risklerhakkında bilgilendirilmesi önemlidir

Anahtar Kelimeler

Neonatal alloimmün trombositopeni tanı tedavi

Kaynakça

  • 1. Dreyfus M, Kaplan C, Verdy E, Schlegel N, Durand-Zaleski I, Tchernia G. Frequency of immune thrombocytopenia in newborns: a prospective study. Immune Thrombocytopenia Working Group. Blood 1997;89:4402-6.
  • 2. Bussel JB, Zabusky MR, Berkowitz RL, McFarland JG. Fetal alloimmune thrombocytopenia. N Engl J Med 1997;337:22-6.
  • 3. Ward MJ, Pauliny J, Lipper EG, Bussel JB. Long-term effects of fetal and neonatal alloimmune thrombocytopenia and its antenatal treatment on the medical and developmental outcomes of affected children. Am J Perinatol 2006;23: 487-92.
  • 4. Burrows RF, Kelton JG. Fetal thrombocytopenia and its rela￾tion to maternal thrombocytopenia. N Engl J Med 1993;329:1463-6.
  • 5. Williamson LM, Hackett G, Rennie J, Palmer CR, Maciver C, Hadfield R et al. The natural history of fetomaternal alloimmunization to the platelet-specific antigen HPA-1a (PlA1, Zwa) as determined by antenatal screening. Blood 1998;92:2280-7.
  • 6. Mueller-Eckhardt C, Kiefel V, Grubert A, Kroll H, Weisheit M, Schmidt S et al. 348 cases of suspected neonatal alloimmune thrombocytopenia. Lancet 1989;1:363-6.
  • 7. Gruel Y, Boizard B, Daffos F, Forestier F, Caen J, Wautier JL. Determination of platelet antigens and glycoproteins in the human fetus. Blood 1986;68:488-92.
  • 8. Spencer JA, Burrows RF. Feto-maternal alloimmune thrombocytopenia: a literature review and statistical analysis. Aust N Z J Obstet Gynaecol 2001;41:45-55.
  • 9. Davoren A, Curtis BR, Aster RH, McFarland JG. Human platelet antigen-specific alloantibodies implicated in 1162 cases of neonatal alloimmune thrombocytopenia. Transfusion 2004;44:1220-5.
  • 10. Rozman P. Platelet antigens. The role of human platelet alloantigens (HPA) in blood transfusion and transplantation. Transpl Immunol 2002;10:165-81.
  • 11. Castro V, Kroll H, Origa AF, Falconi MA, Marques SB, Marba ST et al. A prospective study on the prevalence and risk factors for neonatal thrombocytopenia and platelet alloimmunization among 9332 unselected Brazilian newborns. Transfusion 2007;47:59-66.
  • 12. Bussel JB, Sola-Visner M. Current approaches to the evaluation and management of the fetus and neonate with immune thrombocytopenia. Semin Perinatol 2009;33:35-42.
  • 13. Killie MK, Husebekk A, Kjeldsen-Kragh J, Skogen B. A prospective study of maternal anti-HPA 1a antibody level as a potential predictor of alloimmune thrombocytopenia in the newborn. Haematologica 2008;93:870-7.
  • 14. Kaplan C. Neonatal alloimmune thrombocytopenia. Haematologica 2008;93:805-7.
  • 15. Sharif U, Kuban K. Prenatal intracranial hemorrhage and neurologic complications in alloimmune thrombocytopenia. J Child Neurol 2001;16:838-42.
  • 16. Bussel JB, Zacharoulis S, Kramer K, McFarland JG, Pauliny J, Kaplan C. Clinical and diagnostic comparison of neonatal alloimmune thrombocytopenia to non-immune cases of thrombocytopenia. Pediatr Blood Cancer 2005;45:176-83.
  • 17. Bassler D, Greinacher A, Okascharoen C, Klenner A, Ditomasso J, Kiefel V et al. A systematic review and survey of the management of unexpected neonatal alloimmune thrombocytopenia. Transfusion 2008;48:92-8.
  • 18. Manno CS. Management of bleeding disorders in children. Hematology Am Soc Hematol Educ Program 2005:416-22.
  • 19. Allen D, Verjee S, Rees S, Murphy MF, Roberts DJ. Platelet transfusion in neonatal alloimmune thrombocytopenia. Blood 2007;109:388-9.
  • 20. Kiefel V, Bassler D, Kroll H, Paes B, Giers G, Ditomasso J et al. Antigen-positive platelet transfusion in neonatal alloimmune thrombocytopenia (NAIT). Blood 2006;107:3761-3.
  • 21. McQuilten ZK, Wood EM, Savoia H, Cole S. A review of pathophysiology and current treatment for neonatal alloimmune thrombocytopenia (NAIT) and introducing the Australian NAIT registry. Aust N Z J Obstet Gynaecol 2011;51:191-8.
  • 22. Massey GV, McWilliams NB, Mueller DG, Napolitano A, Maurer HM. Intravenous immunoglobulin in treatment of neonatal isoimmune thrombocytopenia. J Pediatr 1987;111:133-5.
  • 23. Blanchette VS, Johnson J, Rand M. The management of a lloimmune neonatal thrombocytopenia. Baillieres Best Pract Res Clin Haematol 2000;13:365-90.
  • 24. van den Akker ES, Oepkes D. Fetal and neonatal alloimmune thrombocytopenia. Best Practice and Research. Best Pract Res Clin Obstet Gynaecol 2008;22:3-14.
  • 25. Birchall JE, Murphy MF, Kaplan C, Kroll H; European Fetomaternal Alloimmune Thrombocytopenia Study Group. European collaborative study of the antenatal management of feto-maternal alloimmune thrombocytopenia. Br J Haematol 2003;122:275-88.
  • 26. Silver RM, Porter TF, Branch DW, Esplin MS, Scott JR. Neonatal alloimmune thrombocytopenia: antenatal management. Am J Obstet Gynecol 2000;182:1233-8.
  • 27. van den Akker ES, Oepkes D, Lopriore E, Brand A, Kanhai HH. Noninvasive antenatal management of fetal and neonatal alloimmune thrombocytopenia: safe and effective. BJOG 2007;114:469-73.
  • 28. Berkowitz RL, Kolb EA, McFarland JG, Wissert M, Primani A, Lesser M et al. Parallel randomized trials of risk-based therapy for fetal alloimmune thrombocytopenia. Obstet Gynecol 2006;107:91-6.
  • 29. Berkowitz RL, Lesser ML, McFarland JG, Wissert M, Primiani A, Hung C et al. Antepartum treatment without early cordocentesis for standard-risk alloimmune thrombocytopenia: a randomized controlled trial. Obstet Gynecol 2007;110:249-55.
  • 30. Berkowitz RL, Bussel JB, McFarland JG. Alloimmune thrombocytopenia: state of the art 2006. Am J Obstet Gynecol 2006;195:907-13.
  • 31. Metcalfe P, Allen D, Chapman J, Ouwehand WH. Interlaboratory variation in the detection of clinically significant alloantibodies against human platelet alloantigens. Br J Haematol 1997;97:204-7.

Neonatal Alloimmune Thrombocytopenia

Yıl 2011, Cilt: 9 Sayı: 3, 93 - 96, 01.12.2011

Melike Sezgin Evim Adalet Meral Güneş

Öz

Neonatal alloimmune thrombocytopenia is a rare disease causing seriousthrombocytopenia during neotatal period. Antibodies developed against fetalthrombocytes due to fetal-maternal platelet antigen incompatibility causethrombocytopenia both in intrauterine period and afterwards. The clinical symptoms varyfrom mild to severe. Half of the cases occurs during first pregnancy. The recurrence riskincreases in the subsequent pregnancies. The event is limited when the antibodies arecleared away. However, a careful close follow-up is needed both for the mothers andfetus/babies and the treatment should be immediately started when it is indicated. Earlydiagnosis, treatment and giving information to the parents about the risks of thesubsuquent pregnancies are important issues due to increased morbidity and mortalityof the disease

Anahtar Kelimeler

Neonatal alloimmune thrombocytopenia diagnosis treatment

Kaynakça

  • 1. Dreyfus M, Kaplan C, Verdy E, Schlegel N, Durand-Zaleski I, Tchernia G. Frequency of immune thrombocytopenia in newborns: a prospective study. Immune Thrombocytopenia Working Group. Blood 1997;89:4402-6.
  • 2. Bussel JB, Zabusky MR, Berkowitz RL, McFarland JG. Fetal alloimmune thrombocytopenia. N Engl J Med 1997;337:22-6.
  • 3. Ward MJ, Pauliny J, Lipper EG, Bussel JB. Long-term effects of fetal and neonatal alloimmune thrombocytopenia and its antenatal treatment on the medical and developmental outcomes of affected children. Am J Perinatol 2006;23: 487-92.
  • 4. Burrows RF, Kelton JG. Fetal thrombocytopenia and its rela￾tion to maternal thrombocytopenia. N Engl J Med 1993;329:1463-6.
  • 5. Williamson LM, Hackett G, Rennie J, Palmer CR, Maciver C, Hadfield R et al. The natural history of fetomaternal alloimmunization to the platelet-specific antigen HPA-1a (PlA1, Zwa) as determined by antenatal screening. Blood 1998;92:2280-7.
  • 6. Mueller-Eckhardt C, Kiefel V, Grubert A, Kroll H, Weisheit M, Schmidt S et al. 348 cases of suspected neonatal alloimmune thrombocytopenia. Lancet 1989;1:363-6.
  • 7. Gruel Y, Boizard B, Daffos F, Forestier F, Caen J, Wautier JL. Determination of platelet antigens and glycoproteins in the human fetus. Blood 1986;68:488-92.
  • 8. Spencer JA, Burrows RF. Feto-maternal alloimmune thrombocytopenia: a literature review and statistical analysis. Aust N Z J Obstet Gynaecol 2001;41:45-55.
  • 9. Davoren A, Curtis BR, Aster RH, McFarland JG. Human platelet antigen-specific alloantibodies implicated in 1162 cases of neonatal alloimmune thrombocytopenia. Transfusion 2004;44:1220-5.
  • 10. Rozman P. Platelet antigens. The role of human platelet alloantigens (HPA) in blood transfusion and transplantation. Transpl Immunol 2002;10:165-81.
  • 11. Castro V, Kroll H, Origa AF, Falconi MA, Marques SB, Marba ST et al. A prospective study on the prevalence and risk factors for neonatal thrombocytopenia and platelet alloimmunization among 9332 unselected Brazilian newborns. Transfusion 2007;47:59-66.
  • 12. Bussel JB, Sola-Visner M. Current approaches to the evaluation and management of the fetus and neonate with immune thrombocytopenia. Semin Perinatol 2009;33:35-42.
  • 13. Killie MK, Husebekk A, Kjeldsen-Kragh J, Skogen B. A prospective study of maternal anti-HPA 1a antibody level as a potential predictor of alloimmune thrombocytopenia in the newborn. Haematologica 2008;93:870-7.
  • 14. Kaplan C. Neonatal alloimmune thrombocytopenia. Haematologica 2008;93:805-7.
  • 15. Sharif U, Kuban K. Prenatal intracranial hemorrhage and neurologic complications in alloimmune thrombocytopenia. J Child Neurol 2001;16:838-42.
  • 16. Bussel JB, Zacharoulis S, Kramer K, McFarland JG, Pauliny J, Kaplan C. Clinical and diagnostic comparison of neonatal alloimmune thrombocytopenia to non-immune cases of thrombocytopenia. Pediatr Blood Cancer 2005;45:176-83.
  • 17. Bassler D, Greinacher A, Okascharoen C, Klenner A, Ditomasso J, Kiefel V et al. A systematic review and survey of the management of unexpected neonatal alloimmune thrombocytopenia. Transfusion 2008;48:92-8.
  • 18. Manno CS. Management of bleeding disorders in children. Hematology Am Soc Hematol Educ Program 2005:416-22.
  • 19. Allen D, Verjee S, Rees S, Murphy MF, Roberts DJ. Platelet transfusion in neonatal alloimmune thrombocytopenia. Blood 2007;109:388-9.
  • 20. Kiefel V, Bassler D, Kroll H, Paes B, Giers G, Ditomasso J et al. Antigen-positive platelet transfusion in neonatal alloimmune thrombocytopenia (NAIT). Blood 2006;107:3761-3.
  • 21. McQuilten ZK, Wood EM, Savoia H, Cole S. A review of pathophysiology and current treatment for neonatal alloimmune thrombocytopenia (NAIT) and introducing the Australian NAIT registry. Aust N Z J Obstet Gynaecol 2011;51:191-8.
  • 22. Massey GV, McWilliams NB, Mueller DG, Napolitano A, Maurer HM. Intravenous immunoglobulin in treatment of neonatal isoimmune thrombocytopenia. J Pediatr 1987;111:133-5.
  • 23. Blanchette VS, Johnson J, Rand M. The management of a lloimmune neonatal thrombocytopenia. Baillieres Best Pract Res Clin Haematol 2000;13:365-90.
  • 24. van den Akker ES, Oepkes D. Fetal and neonatal alloimmune thrombocytopenia. Best Practice and Research. Best Pract Res Clin Obstet Gynaecol 2008;22:3-14.
  • 25. Birchall JE, Murphy MF, Kaplan C, Kroll H; European Fetomaternal Alloimmune Thrombocytopenia Study Group. European collaborative study of the antenatal management of feto-maternal alloimmune thrombocytopenia. Br J Haematol 2003;122:275-88.
  • 26. Silver RM, Porter TF, Branch DW, Esplin MS, Scott JR. Neonatal alloimmune thrombocytopenia: antenatal management. Am J Obstet Gynecol 2000;182:1233-8.
  • 27. van den Akker ES, Oepkes D, Lopriore E, Brand A, Kanhai HH. Noninvasive antenatal management of fetal and neonatal alloimmune thrombocytopenia: safe and effective. BJOG 2007;114:469-73.
  • 28. Berkowitz RL, Kolb EA, McFarland JG, Wissert M, Primani A, Lesser M et al. Parallel randomized trials of risk-based therapy for fetal alloimmune thrombocytopenia. Obstet Gynecol 2006;107:91-6.
  • 29. Berkowitz RL, Lesser ML, McFarland JG, Wissert M, Primiani A, Hung C et al. Antepartum treatment without early cordocentesis for standard-risk alloimmune thrombocytopenia: a randomized controlled trial. Obstet Gynecol 2007;110:249-55.
  • 30. Berkowitz RL, Bussel JB, McFarland JG. Alloimmune thrombocytopenia: state of the art 2006. Am J Obstet Gynecol 2006;195:907-13.
  • 31. Metcalfe P, Allen D, Chapman J, Ouwehand WH. Interlaboratory variation in the detection of clinically significant alloantibodies against human platelet alloantigens. Br J Haematol 1997;97:204-7.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Case Report
Yazarlar

Melike Sezgin Evim

Adalet Meral Güneş Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2011
Yayımlandığı Sayı Yıl 2011 Cilt: 9 Sayı: 3

Kaynak Göster

APA Evim, M. S., & Güneş, A. M. (2011). Neonatal Alloimmün Trombositopeni. Güncel Pediatri, 9(3), 93-96.
AMA Evim MS, Güneş AM. Neonatal Alloimmün Trombositopeni. Güncel Pediatri. Aralık 2011;9(3):93-96.
Chicago Evim, Melike Sezgin, ve Adalet Meral Güneş. “Neonatal Alloimmün Trombositopeni”. Güncel Pediatri 9, sy. 3 (Aralık 2011): 93-96.
EndNote Evim MS, Güneş AM (01 Aralık 2011) Neonatal Alloimmün Trombositopeni. Güncel Pediatri 9 3 93–96.
IEEE M. S. Evim ve A. M. Güneş, “Neonatal Alloimmün Trombositopeni”, Güncel Pediatri, c. 9, sy. 3, ss. 93–96, 2011.
ISNAD Evim, Melike Sezgin - Güneş, Adalet Meral. “Neonatal Alloimmün Trombositopeni”. Güncel Pediatri 9/3 (Aralık 2011), 93-96.
JAMA Evim MS, Güneş AM. Neonatal Alloimmün Trombositopeni. Güncel Pediatri. 2011;9:93–96.
MLA Evim, Melike Sezgin ve Adalet Meral Güneş. “Neonatal Alloimmün Trombositopeni”. Güncel Pediatri, c. 9, sy. 3, 2011, ss. 93-96.
Vancouver Evim MS, Güneş AM. Neonatal Alloimmün Trombositopeni. Güncel Pediatri. 2011;9(3):93-6.