Current perspectives on fetal and neonatal alloimmune thrombocytopenia – increasing clinical concerns and new treatment opportunities

Abstract

Heidi Tiller,1 Anne Husebekk,1 Maria Therese Ahlen,2 Tor B Stuge,1 Bjørn Skogen3 1Immunology Research Group, Faculty of Health Sciences, UiT, The Arctic University of Norway, 2Division of Diagnostic Services, Department of Laboratory Medicine, 3Department of Laboratory Medicine, Norwegian National Unit for Platelet Immunology, University Hospital of North Norway, Tromsø, Norway Abstract: Differences in platelet type between the fetus and the mother can lead to maternal immunization and destruction of the fetal platelets, a condition named fetal and neonatal alloimmune thrombocytopenia (FNAIT). FNAIT is reported to occur in ~1 per 1,000 live born neonates. The major risk is intracranial hemorrhage in the fetus or newborn, which is associated with severe neurological complications or death. Since no countries have yet implemented a screening program to detect pregnancies at risk, the diagnosis is typically established after the birth of a child with symptoms. Reports on broader clinical impact have increased clinical concern and awareness. Along with new treatment options for FNAIT, the debate around antenatal screening to detect pregnancies at risk of FNAIT has been revitalized. Keywords: antibodies, screening, alloimmunization, platelets, newborn, pregnancy

Keywords

• Thrombocytopenia
• antibodies
• screening
• alloimmunization
• platelets