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Alloimmunization pregnancy

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https://www.readbyqxmd.com/read/27913514/understanding-red-blood-cell-alloimmunization-triggers
#1
Jeanne E Hendrickson, Christopher A Tormey
Blood group alloimmunization is "triggered" when a person lacking a particular antigen is exposed to this antigen during transfusion or pregnancy. Although exposure to an antigen is necessary for alloimmunization to occur, it is not alone sufficient. Blood group antigens are diverse in structure, function, and immunogenicity. In addition to red blood cells (RBCs), a recipient of an RBC transfusion is exposed to donor plasma, white blood cells, and platelets; the potential contribution of these elements to RBC alloimmunization remains unclear...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27882754/-fetal-alloimmune-thrombocytopenia-in-pregnant-woman-with-anti-hpa-1a-antibodies
#2
K Sobíšková, J Matěcha
OBJECT: Description of the pregnancy in patient with anti-HPA-1a antibodies. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital. CASE REPORT: Report of cases of neonatal alloimune thrombocytopenia in a patient with proven anti-HPA 1a antibodies. The immunization developed during the first pregnancy, accompanied with fetal thrombocytopenia which recurred in every subsequent pregnancy with greater severity...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27872733/hyperhemolytic-syndrome-complicating-a-delayed-hemolytic-transfusion-reaction-due-to-anti-p1-alloimmunization-in-a-pregnant-woman-with-hbo-arab-%C3%AE-thalassemia
#3
Zoe Bezirgiannidou, Anna Christoforidou, Eftychia Kontekaki, Athanasios G Anastasiadis, Spyros I Papamichos, Helen Menexidou, Dimitrios Margaritis, Georges Martinis, Elpis Mantadakis
BACKGROUND: Hyperhemolytic Syndrome or Hyperhemolytic Transfusion Reaction (HHTR), a life-threatening subset of Delayed Hemolytic Transfusion Reaction (DHTR) is characterized by destruction of both transfused and autologous erythrocytes evidenced by a fall in post transfusion hemoglobin below the pre-transfusion level. CASE REPORT: We describe a case of DHTR due to anti-P1 alloimmunization manifesting with hyperhemolysis in a 30-year-old Greek Pomak woman with thalassemia intermedia (HbO-Arab/β-thalassemia), during the11(th) week of her first gestation...
2016: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27871460/placental-histological-lesions-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-retrospective-cohort-study-of-21-cases
#4
Estelle Dubruc, Frédérique Lebreton, Catherine Giannoli, Muriel Rabilloud, Cyril Huissoud, Mojgan Devouassoux-Shisheboran, Fabienne Allias
BACKGROUND: Alloimmunization against human platelet antigens (HPAs) can occur prenatally and induce fetal/neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to identify placental histological features associated with platelet alloimmunization and their clinical significance. METHODS: This study examined 21 placentas from FNAIT-affected pregnancies and 42 age-matched control cases, all collected from pathology departments in the Rhône-Alpes region...
December 2016: Placenta
https://www.readbyqxmd.com/read/27869421/-gestational-alloimmune-liver-disease-a-case-report
#5
Sara Laliena Aznar, Inés Martínez Redondo, María J Oliván Del Cacho, María Martínez Del Moral, Raquel Pinillos Pisón
Gestational alloimmune liver disease, previously known as neonatal hemochromatosis, is characterized by severe liver disease in neonatal period, associated with intra and extrahepatic iron accumulation. It is postulated an alloimmune origin, which has opened new opportunities in the treatment and prevention during risk pregnancies, changing the prognosis of this pathology. We report the case of a newborn that presents early liver failure, with clinical and analytical features compatible with gestational alloimmune liver disease...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27829878/glanzmann-thrombasthenia-in-pregnancy-optimising-maternal-and-fetal-outcomes
#6
A Wijemanne, I Watt-Coote, S Austin
Glanzmann thrombasthenia is a rare autosomal recessive haemorrhagic disorder. The risks of miscarriage, antepartum and postpartum haemorrhage, and neonatal complications are all increased in individuals presenting with the disease in pregnancy. Some individuals may develop antibodies to platelet glycoproteins; the presence of these antibodies is a rare cause of neonatal alloimmune thrombocytopenia and potential intracranial haemorrhage. Multidisciplinary care is paramount for ensuring optimal fetal and maternal outcomes in such cases...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27806668/contemporary-management-of-neonatal-alloimmune-thrombocytopenia-good-outcomes-in-the-intravenous-immunoglobulin-era-results-from-the-australian-neonatal-alloimmune-thrombocytopenia-registry
#7
Gemma L Crighton, Ri Scarborough, Zoe K McQuilten, Louise E Phillips, Helen F Savoia, Bronwyn Williams, Rhonda Holdsworth, Amanda Henry, Erica M Wood, Stephen A Cole
OBJECTIVE: To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT Registry. METHODS: Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies. RESULTS: 94 potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT...
November 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27803521/anti-m-alloimmunization-in-pregnancy-an-unusual-cause-of-bad-obstetric-history
#8
Rakhi Rai, Subhas Chandra Saha, Ashish Jain, Rashmi Bagga, Praveen Kumar, Neelam Marwaha
No abstract text is available yet for this article.
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27797412/prevalence-of-granulocyte-antibodies-in-never-allo-exposed-female-and-male-donors
#9
Rutger A Middelburg, Hans Vrielink, Leendert Porcelijn
BACKGROUND: Fetal/Neonatal alloimmune neutropenia (FNAIN) is a serious condition usually resulting from immunisation of the mother to paternally inherited neutrophil antigens of the foetus. Understanding the biology of female immunisation against neutrophils could help predict or prevent FNAIN. OBJECTIVES: To quantify differences in the prevalence of specific and pan-reactive granulocyte antibodies, between allo-exposed and never allo-exposed male and female blood donors...
October 31, 2016: European Journal of Haematology
https://www.readbyqxmd.com/read/27753021/non-invasive-prenatal-diagnosis-of-feto-maternal-platelet-incompatibility-by-cold-high-resolution-melting-analysis
#10
Marta Ferro, Hada C Macher, Pilar Noguerol, Pilar Jimenez-Arriscado, Patrocinio Molinero, Juan M Guerrero, Amalia Rubio
Fetal and Neonatal alloimmune thrombocytopenia (FNAIT) is a condition which could occur when pregnant women develop an alloimmunization against paternally inherited antigens of the fetal platelets. Approximately 80 % of FNAIT cases are caused by anti-HPA-1a, about 15 % by anti-HPA-5b and 5 % by other HPA antibodies. Only 2 % of the total population is HPA-1a negative (HPA-1b1b). The HPA-1a allele differs by one single nucleotide from HPA-1b allele, yet it represents around 27 % of total severe thrombocytopenias...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27748520/maternal-hla-genotyping-is-not-useful-for-predicting-severity-of-fetal-and-neonatal-alloimmune-thrombocytopenia
#11
Susanna Sainio, Kaija Javela, Jarno Tuimala, Katri Haimila
Lack of reliable laboratory parameters is the main challenge in the management of fetal and neonatal alloimmune thrombocytopenia (FNAIT). Despite the long-known association between the HLA-DRB3*01:01 allele and human platelet antigen 1a (HPA-1a) alloimmunisation, maternal human leucocyte antigen (HLA) typing has been of little clinical value. Recently, other DRB3 allele variants have been suggested to predict the severity of FNAIT. In this nationwide population-based retrospective cohort study, we performed extensive HLA typing of 96 women, accounting for 87% of our cohort of 110 families with confirmed or possible HPA-1a-immunisation...
October 17, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27741190/gestational-alloimmune-liver-disease-a-devastating-condition-preventable-with-maternal-intravenous-immunoglobulin
#12
Hannah B Anastasio, Maureen Grundy, Meredith L Birsner, Karin J Blakemore
BACKGROUND: Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise has a recurrence risk above 90% in subsequent pregnancies. CASE: A 30-year-old woman, gravida 3 para 0120, presented early in gestation. Her previous pregnancy had been complicated by fetal growth restriction, oligohydramnios, and ultimately fatal fulminant neonatal liver failure...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27728915/fetal-and-neonatal-alloimmune-thrombocytopenia-management-and-outcome-of-a-large-international-retrospective-cohort
#13
Marije M Kamphuis, Heidi Tiller, E S van den Akker, Magnus Westgren, Eleonor Tiblad, Dick Oepkes
OBJECTIVE: To evaluate the management and outcome of a large international cohort of cases of pregnancies complicated by fetal and neonatal alloimmune thrombocytopenia (FNAIT). METHODS: This was an observational prospective and retrospective cohort study of all cases of FNAIT entered into the international multicentre No IntraCranial Haemorrhage (NOICH) registry during the period of 2001-2010. We evaluated human platelet antigen (HPA) specificity, the antenatal and postnatal interventions performed, and clinical outcome...
October 12, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27706858/complications-of-intrauterine-intravascular-blood-transfusions-lessons-learned-after-1678-procedures
#14
Carolien Zwiers, Irene T M Lindenburg, Frans J C M Klumper, Masja de Haas, Dick Oepkes, Inge L van Kamp
BACKGROUND: maternal alloimmunization to fetal red blood cell antigens is a major cause of fetal anemia, which in untreated cases can lead to hydrops and perinatal death. The cornerstone of the management during pregnancy is intrauterine intravascular blood transfusion. Although this procedure is considered to be relatively safe, (procedure-related) complications continue to occur. OBJECTIVES: to evaluate procedure-related complications and perinatal loss rates of intrauterine transfusion and changes over time, aiming to identify factors leading to improved outcome...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27699233/t-cell-responses-to-human-platelet-antigen-1a-involve-a-unique-form-of-indirect-allorecognition
#15
Maria Therese Ahlen, Anne Husebekk, Ida Løken Killie, Bjørn Skogen, Tor Brynjar Stuge
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a pregnancy-related condition caused by maternal antibodies binding an alloantigen on fetal platelets. In most cases the alloantigen is formed by a single amino acid, integrin β3 Leu33, referred to as human platelet antigen-1a (HPA-1a). Production of anti-HPA-1a antibodies likely depends on CD4(+) T cells that recognize the same alloantigen in complex with the HLA-DRA/DRB3*01:01 molecule. While this complex is well characterized, T cell recognition of it is not...
September 8, 2016: JCI Insight
https://www.readbyqxmd.com/read/27688803/antigen-modulation-as-a-potential-mechanism-of-anti-kel-immunoprophylaxis-in-mice
#16
Jingchun Liu, Manjula Santhanakrishnan, Prabitha Natarajan, David R Gibb, Stephanie C Eisenbarth, Christopher A Tormey, Alexa J Siddon, Sean R Stowell, Donald R Branch, Jeanne E Hendrickson
RBC alloimmunization is a serious complication of transfusion or pregnancy. Despite the widespread use of RhIg to prevent pregnancy associated anti-D alloimmunization, its mechanism of action remains elusive. We have previously described a murine model in which immunoprophylaxis with polyclonal anti-KEL sera prevents alloimmunization in wild type recipients transfused with transgenic murine RBCs expressing the human KEL glycoprotein. To investigate the mechanism of action, we have now evaluated the outcome of immunoprophylaxis treatment in mice lacking Fcγ receptors (FcγR), complement (C3), both, or none...
September 29, 2016: Blood
https://www.readbyqxmd.com/read/27668201/etiologic-characteristics-and-index-pregnancy-outcomes-of-recurrent-pregnancy-losses-in-korean-women
#17
Gi Su Lee, Joon Cheol Park, Jeong Ho Rhee, Jong In Kim
OBJECTIVE: The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses. METHODS: One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation...
September 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27627660/anti-human-platelet-antigen-1a-immunoglobulin-g-preparation-intended-to-prevent-fetal-and-neonatal-alloimmune-thrombocytopenia
#18
Ying-Jan Weng, Anne Husebekk, Björn Skogen, Mette Kjaer, Liang-Tzung Lin, Thierry Burnouf
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a severe disease that is caused by maternal alloantibodies generated during pregnancy or at delivery as a result of incompatibility between maternal and fetal human platelet antigens (HPAs) inherited from the father. Antibody-mediated immune suppression using anti-HPA-1a immunoglobulins is thought to be able to prevent FNAIT caused by HPA-1a. A fractionation process to prepare anti-HPA-1a immunoglobulin (Ig) G (IgG) from human plasma was therefore developed...
2016: PloS One
https://www.readbyqxmd.com/read/27611703/blood-group-a-mothers-are-more-likely-to-develop-anemia-during-antenatal-intravenous-immunoglobulin-treatment-of-fetal-and-neonatal-alloimmune-thrombocytopenia
#19
Madhavi Lakkaraja, Jenny C Jin, Karen C Manotas, Cheryl A Vinograd, Polina Ferd, Julia Gabor, Megan Wissert, Richard L Berkowitz, Janice G McFarland, James B Bussel
BACKGROUND: Incompatibility between parental platelet (PLT) antigens may lead to sensitization of mother and development of fetal and neonatal alloimmune thrombocytopenia (FNAIT) resulting in fetal thrombocytopenia. Intravenous immunoglobulin (IVIG) with or without prednisone is the most effective, evidence-based antenatal treatment for subsequent FNAIT-affected pregnancies. IVIG infusion causes hemolysis in other settings, the degree depending upon patient blood groups (BGs). STUDY DESIGN AND METHODS: In ClinicalTrials...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27610256/extreme-elevation-of-alkaline-phosphatase-in-a-pregnancy-complicated-by-gestational-diabetes-and-infant-with-neonatal-alloimmune-thrombocytopenia
#20
Svjetlana Lozo, Amir Atabeygi, Michael Healey
There have been few case reports of isolated elevation of alkaline phosphatase beyond the normal physiologic amount with subsequent return to baseline after delivery. Here we present a similar case of extreme elevation of alkaline phosphatase in a pregnancy complicated by gestational diabetes and subsequently by neonatal alloimmune thrombocytopenia (NAIT).
2016: Case Reports in Obstetrics and Gynecology
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