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Alloimmunization pregnancy

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https://www.readbyqxmd.com/read/28295360/human-platelet-antigen-antibody-induction-in-uncomplicated-pregnancy-is-associated-with-hla-sensitization
#1
Viktoria S A Reiher, Gideon Hönger, Laura Infanti, Jakob R Passweg, Irene Hösli, Beat M Frey, Christoph Gassner, Stefan Meyer, Andreas S Buser, Andreas Holbro, Stefan Schaub
BACKGROUND: Alloimmunization against human platelet antigens (HPAs) during pregnancy is rare but can lead to severe bleeding disorders, such as fetal and neonatal alloimmune thrombocytopenia. STUDY DESIGN AND METHODS: In a cohort of 241 uncomplicated pregnancies, we investigated the immunogenicity of HPA mismatches and correlated HLA sensitization with HPA antibody formation. HPA antibodies were measured with a Luminex-based multiplex assay. RESULTS: HPA mismatches were observed in 109 of 241 pregnancies (45%), but child-specific HPA antibodies were only found in two of 109 cases (2%), indicating a low immunogenicity...
March 10, 2017: Transfusion
https://www.readbyqxmd.com/read/28275334/clinical-significance-of-an-alloantibody-against-the-kell-blood-group-glycoprotein
#2
Stella Maris Mattaloni, Carine Arnoni, Rosario Céspedes, Claudia Nonaka, Carolina Trucco Boggione, Melina Eliana Luján Brajovich, Andrea Trejo, Néstor Zani, Claudia Silvia Biondi, Lilian Castilho, Carlos Miquel Cotorruelo
BACKGROUND: Kell null (K0) individuals can produce anti-Ku, an antibody against many epitopes in the Kell glycoprotein, after transfusion and/or pregnancy. Since sensitized K0 patients are rare, little is known about anti-Ku clinical relevance and in particular about its association to hemolytic disease of the fetus and newborn. CASE REPORT: This work describes a case of neonatal hyperbilirubinemia due to immune-mediated erythrocyte destruction by an alloantibody directed against the Kell glycoprotein...
January 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28262226/taking-a-wider-view-on-fetal-neonatal-alloimmune-thrombocytopenia
#3
Lilach Bonstein, Nuhad Haddad
In fetal/neonatal alloimmune thrombocytopenia (FNAIT), platelets are destroyed by maternal antibodies directed against fetal/neonate antigens. Thrombocytopenia can be severe and lead to intracranial hemorrhage (ICH) in about 10% of cases. Although three types of antigen groups, presented on platelets [ABO blood group antigens, human leukocyte antigens (HLA) and human platelet antigens (HPA)] are known to be implicated in immune platelet destruction, antibodies against HPA are most commonly involved in FNAIT and hence are the target of extensive research...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28240400/low-dose-prednisone-and-immunoglobulin-g-treatment-for-woman-at-risk-for-neonatal-alloimmune-thrombocytopenia-and-t-helper-1-immunity
#4
Annie Skariah, Nayoung Sung, Maria D Salazar Garcia, Li Wu, Anjali Tikoo, Alice Gilman-Sachs, Joanne Kwak-Kim
PROBLEM: Fetal and neonatal alloimmune thrombocytopenia is an alloimmune disorder resulting from platelet opsonization by maternal antibodies that destroy fetal platelets. As there is no antenatal screening or immunization to prevent sensitization, selection of high-risk population or the prevention of antenatal sensitization is significantly limited. METHOD OF STUDY: (i) A case report of ante- and postnatal management of a woman with paternal homozygosity for human platelet antigen-1(HPA) incompatibility...
February 27, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28180200/acoustic-radiation-force-impulse-elastosonography-of-placenta-in-maternal-red-blood-cell-alloimmunization-a-preliminary-and-descriptive-study
#5
Orkun Cetin, Erbil Karaman, Harun Arslan, Ibrahim Akbudak, Recep Yıldızhan, Ali Kolusarı
AIMS: Maternal red blood cell alloimmunization is an important cause of fetal morbidity and mortality in the perinatal period, despite well-organized prophylaxis programs. The objective of the study was to evaluate placental elasticity by using Acoustic Radiation Force Impulse (ARFI) in Rhesus (Rh) alloimmunized pregnant women with hydropic and nonhydropic fetuses and to compare those with healthy pregnant women. MATERIAL AND METHODS: This case-control and descriptive study comprised twenty-eight healthy pregnant women, 14 Rh alloimmunized pregnant women with nonhydropic fetuses, and 16 Rh alloimmunized pregnant women with hydropic fetuses in the third trimester of pregnancy...
January 31, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28164304/blood-group-antigen-matching-influence-on-gestational-outcomes-amigo-study
#6
Meghan Delaney, Agneta Wikman, Leo van de Watering, Henk Schonewille, Jennie P Verdoes, Stephen P Emery, Michael F Murphy, Julie Staves, Susanne Flach, Donald M Arnold, Richard M Kaufman, Alyssa Ziman, Sarah K Harm, Mark Fung, Catherine S Eppes, Nancy M Dunbar, Andreas Buser, Erin Meyer, Helen Savoia, Padmakumari Abeysinghe, Nancy Heddle, Alan Tinmouth, Aicha N Traore, Mark H Yazer
BACKGROUND: Red blood cell (RBC) antigen matching policies to prevent alloimmunization in females of childbearing potential (FCP) vary between centers. To inform transfusion centers responsible for making decisions about matching policies for FCPs, the causal stimulus of the antibodies implicated in severe hemolytic disease of the fetus and newborn (HDFN) must be determined. STUDY DESIGN AND METHODS: We conducted a multinational retrospective study of women with offspring affected by severe HDFN requiring neonatal exchange transfusion and/or intrauterine transfusion...
March 2017: Transfusion
https://www.readbyqxmd.com/read/28130210/antenatal-management-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-systematic-review
#7
Dian Winkelhorst, Michael F Murphy, Andreas Greinacher, Nadine Shehata, Tamam Bakchoul, Edwin Massey, Jillian Baker, Lani Lieberman, Susano Tanael, Heather Hume, Donald M Arnold, Shoma Baidya, Gerald Bertrand, James Bussel, Mette Kjaer, Cécile Kaplan, Jens Kjeldsen-Kragh, Dick Oepkes, Greg Ryan
Several strategies can be used to manage fetal or neonatal alloimmune thrombocytopenia (FNAIT) in subsequent pregnancies. Serial fetal blood sampling (FBS) and intrauterine platelet transfusions (IUPT), and weekly maternal intravenous immunoglobulin infusion (IVIG), with or without additional corticosteroid therapy are common options, but the optimal management has not been determined. The aim of this systematic review was to assess antenatal treatment strategies for FNAIT. Four randomized controlled trials and twenty-two non-randomized studies were included...
January 27, 2017: Blood
https://www.readbyqxmd.com/read/28097780/a-man-made-disease-fetal-neonatal-alloimmune-thrombocytopenia-due-to-incompatibility-between-oocyte-donor-and-gestational-mother
#8
Assaf Arie Barg, Aviya Dvir Ifrah, Tzipi Strauss, Michal J Simchen, Raoul Orvieto, Nurit Rosenberg, Gili Kenet
The incompatibility causing fetal and neonatal alloimmune thrombocytopenia (FNAIT) results from a fetus inheriting a paternal human platelet antigen (HPA), which is different from the maternal HPA. We present a unique case of FNAIT in a pregnancy involving an oocyte recipient mother with Turner syndrome. This is the first report of FNAIT in which the suggested mechanism involves antibodies produced by a gestational mother against the incompatible HPA of the oocyte donor.
January 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28052334/association-of-hla-drb1-and-hla-dqb1-with-red-blood-cell-alloimmunization-in-the-czech-population
#9
A Maluskova, F Mrazek, M Pauliskova, P Kovarova, M Koristka, P Jindra, Z Cermakova
BACKGROUND AND OBJECTIVES: Alloimmune antibodies against red-blood-cell (RBC) antigens induced in susceptible individuals (responders) by transfusion, pregnancy or transplantation may have serious clinical consequences. The aim of this study was to investigate association of alloimmunization against selected RBC antigens with HLA-Class II. MATERIALS AND METHODS: A total of 230 responders (106 monoresponders and 124 multiresponders) were enrolled into the study. HLA-DRB1 and HLA-DQB1 variants were determined by PCR-SSO and their frequencies compared between the patients (patient subgroups) and 375 ethnically and regionally matched controls...
February 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/27913514/understanding-red-blood-cell-alloimmunization-triggers
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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: Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT...
November 24, 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
#17
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
#18
Rutger A Middelburg, Hans Vrielink, Leendert Porcelijn
BACKGROUND: Foetal/neonatal allo-immune 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...
March 2017: 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
#19
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
#20
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...
January 2017: British Journal of Haematology
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