998-Neonatal Alloimmune Thrombocytopenia

Course # DL-998: Neonatal Alloimmune Thrombocytopenia

by Abigail Moss, BS, CLS, School of Allied Health - Loma Linda University, Loma Linda, CA

&

Katherine Davis, MS, CLS, Program Director, Clinical Laboratory Sciences Program - Loma Linda University School of Allied Health Professions - Department of Clinical Laboratory Science, Loma Linda, CA

Approved for 1.0 CE
Level of Difficulty: Intermediate

Abstract:

The patient presents as a 26 year-old gravida 3 para1 female. She has a history of neonatal alloimmune thrombocytopenia (NAIT) in a previous pregnancy and now has another affected pregnancy. NAIT is a little-known disease that poses a major problem for both the fetus and the physician. In NAIT the mother produces antibodies against fetal platelet antigens. These antibodies can cross the placenta as early as 17 weeks of gestation. Consequences of the antibody passage can be minimal or as serious as intracranial hemorrhage (ICH) that could lead to primary hemorrhagic morbidity. Most cases are not diagnosed until the index case is discovered, as in this patient’s losing a fetus at 36 weeks. During the present pregnancy fetal platelet transfusions were performed and the mother received intravenous immune globulin (IVIG)/prednisone injections every week. The baby was delivered via Caesarian section and after a four week hospital stay was discharged. No evidence of ICH was shown and no additional transfusions were necessary.

Objectives:

After completing this course the participant will be able to:

  1. describe NAIT and its prevalence
  2. outline the platelet antigens most frequently involved in Caucasians and Asians
  3. discuss the laboratory tests involved in diagnosis and treatment of NAIT
  4. outline a treatment method in controlling a severe case of NAIT
  5. describe methods used to diagnose possible NAIT in a fetus
  6. discuss methods of preventing manifestations of NAIT in an at-risk fetus

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