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Severe neonatal neutropenia due to anti‐human leucocyte antigen B49 alloimmunization only: a case report
Author(s) -
Tomičić M.,
Starčević M.,
Bux J.,
Zach V.,
HundrićHašpl Ž.,
Dražić V.,
Grahovac B.
Publication year - 2003
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1046/j.1365-3148.2003.00446.x
Subject(s) - immunology , human leukocyte antigen , neonatal alloimmune thrombocytopenia , medicine , antibody , serology , neutropenia , isoantibodies , antigen , granulocyte , biology , pregnancy , fetus , chemotherapy , genetics
Summary. Alloimmune neonatal neutropenia (ANN) is a rare but potentially life‐threatening disorder of neonates. Demonstration of alloantibodies against granulocyte‐specific antigens shared by neonatal and paternal granulocytes in the maternal serum is essential in the diagnosis of ANN. In contrast to granulocyte‐specific alloantibodies, the significance of human leucocyte antigen (HLA) class I antibodies for ANN is still a matter of debate. We report on a case of severe isolated and prolonged neutropenia due to anti‐HLA B49 alloimmunization only. Immediately after birth, severe, isolated neutropenia was observed and lasted for up to 2 months. Results of serologic testing showed only anti‐HLA B49 antibodies in the maternal and neonate's sera. HLA typing showed HLA class I (B49) incompatibility between the mother and the child. Granulocyte‐specific antibodies were not detected. Adsorption of the maternal serum with HLA B49‐bearing platelets removed serum reactivity with paternal neutrophils. Our results support the idea that certain HLA class I antibodies can induce ANN.