Case 08 (2025): Neonatal alloimmune thrombocytopenia mediated by human leukocyte antigen
10.3760/cma.j.cn113903-20250322-00141
- VernacularTitle:病例08(2025):人类白细胞抗原介导的新生儿同族免疫性血小板减少性紫癜1例
- Author:
Lisha LIN
1
;
Lishan GUO
1
;
Xiaoyan SONG
1
;
Weibin WU
1
;
Linmei JIANG
1
;
Hongwu CHEN
1
;
Qiqiong WANG
1
Author Information
1. 南方医科大学南方医院新生儿科,广州 510515
- Publication Type:Journal Article
- Keywords:
Neonatal alloimmune thrombocytopenia;
Purpura;
Anemia;
Human leukocyte antigen
- From:
Chinese Journal of Perinatal Medicine
2025;28(8):682-688
- CountryChina
- Language:Chinese
-
Abstract:
This report described a case of neonatal alloimmune thrombocytopenic purpura presenting with generalized petechiae. The infant was admitted at Nanfang Hospital, Southern Medical University on March 30, 2022, following detection of wide spread petechiae 30 minutes post-delivery. Blood tests revealed severe thrombocytopenia (platelet count 5×10 9/L) with leukopenia, decreased hemoglobin, and hepatomegaly, though coagulation function remained normal. Initial treatments—random donor platelet transfusion, and intravenous immunoglobulin—proved ineffective. Pretreatment blood samples showed strongly positive platelet antibodies (3+). Further typing confirmed human leukocyte antigen (HLA) antibodies in both infant and mother, establishing HLA-negative neonatal alloimmune thrombocytopenia. HLA-negative platelet transfusion resolved petechiae and normalized platelet counts, enabling discharge on postnatal day 14. Subdural hemorrhage was detected on MRI at day 29. Platelet levels remained normal at six-month follow-up, with age-appropriate development confirmed at 2.5 years.