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Chapter 14 - Fetal and Neonatal Alloimmune Thrombocytopenias

from Section IV - Platelet Disorders

Published online by Cambridge University Press:  30 January 2021

By
W. Beau Mitchell  and
James B. Bussel
Edited by
Pedro A. de Alarcón ,
Eric J. Werner ,
Robert D. Christensen  and
Martha C. Sola-Visner
Pedro A. de Alarcón
Affiliation:
University of Illinois College of Medicine
Eric J. Werner
Affiliation:
Children's Hospital of the King's Daughters
Robert D. Christensen
Affiliation:
University of Utah
Martha C. Sola-Visner
Affiliation:
Harvard University, Massachusetts
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Summary

Fetal and neonatal alloimmune thrombocytopenia (AIT) is the most common cause of severe thrombocytopenia in fetuses and neonates [1]. Maternal IgG alloantibodies against paternally derived fetal platelet antigens cross the placenta early in pregnancy and commonly result in severe thrombocytopenia. While the reported incidence varies somewhat with the assigned threshold of thrombocytopenia (50, 100, or 150 × 109/L), in most unselected populations AIT affects 1 in 1,000 live births. Table 14.1 displays the studies of AIT in unselected populations, systematically screened. In its severe form, AIT has the potential for significant morbidity (including intracranial hemorrhage in utero) and mortality. In milder forms, there are either antibodies with no thrombocytopenia, or mild to moderate thrombocytopenia, which is identified only by a complete blood count obtained for another indication or in a screening study. While there have been extensive efforts made in the diagnosis and characterization of the disease, strategies for early detection and intervention remain controversial.

Type
Chapter
Information
Neonatal Hematology
Pathogenesis, Diagnosis, and Management of Hematologic Problems
 , pp. 223 - 242
Publisher: Cambridge University Press
Print publication year: 2021

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