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Revista Cubana de Pediatría

versão On-line ISSN 1561-3119

Resumo

SOLER NODA, Gilberto; ROMERO DIAZ, Yisenia; FORRELLAT BARRIOS, Mariela  e  BENCOMO HERNANDEZ, Antonio. Current knowledge on neonatal alloimmune thrombocytopenia’s pathogenesis, clinical presentation, diagnostic and management. Rev Cubana Pediatr [online]. 2019, vol.91, n.3  Epub 01-Set-2019. ISSN 1561-3119.

Introduction:

Neonatal alloimmune thrombocytopenia is a disease produced by maternal antibodies against fetal platelet antigens inherited from the father. It can be a cause of intracranial hemorrhage and lead to death or disability in the fetus / neonate. Although it is the most serious cause of thrombocytopenia in newborns and the most common in full-term infants, it has generally been poorly investigated.

Objectives:

To approximate to current knowledge about the pathogenesis, clinical presentation, diagnosis and pre- and post-natal management of neonatal alloimmune thrombocytopenia.

Methods:

A review of literature, in English and Spanish, through PubMed website and Google scholar search engine of articles published in the last 10 years was conducted. An analysis and summary of the reviewed bibliography was made.

Results:

Maternal IgG antibodies are transported through the placenta to the fetal circulation, opsonizing fetal platelets that are removed by phagocytosis. The most involved antigens are HPA-1a and HPA-4a. The pathophysiology of this disease is very similar to perinatal hemolytic disease, but research programs have not been implemented yet and diagnosis is made after birth of children affected by thrombocytopenia, intracranial hemorrhage or in uterus death by unexplained causes.

Final considerations:

Clinical impacts of neonatal alloimmune thrombocytopenia and treatment opportunities enhance the need to implement screening programs for the detection of fetuses at risk of suffering from this disease.

Palavras-chave : neonatal alloimmune thrombocytopenia; NAIT; human platelet antigens; HPA; pregnancy.

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