Neonatal Alloimmune Thrombocytopenia Caused by Anti-HLA-A2 Alloantibodies Determined by Luminex Single Antigen Bead Assay

Yoonjoo Kim; Eun-Jee Oh; Yonggoo Kim; Juyoung Lee; In Kyung Sung

doi:10.3343/lmo.2013.3.1.45

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Kim, Oh, Kim, Lee, and Sung: Neonatal Alloimmune Thrombocytopenia Caused by Anti-HLA-A2 Alloantibodies Determined by Luminex Single Antigen Bead Assay

Case Report

Transfusion Medicine

Laboratory Medicine Online

Laboratory Medicine Online 2013; 3(1): 45-49.

Published online: 1 January 2013

DOI: https://doi.org/10.3343/lmo.2013.3.1.45

Neonatal Alloimmune Thrombocytopenia Caused by Anti-HLA-A2 Alloantibodies Determined by Luminex Single Antigen Bead Assay

Yoonjoo Kim, M.D.¹, Eun-Jee Oh, M.D.¹, Yonggoo Kim, M.D.¹, Juyoung Lee, M.D.², In Kyung Sung, M.D²

¹Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.

²Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea.

Corresponding author: Yonggoo Kim, M.D. Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-1642, Fax: +82-2-2258-1719, yonggoo@catholic.ac.kr

Received 21 March 2012 Revised 5 June 2012 Accepted 20 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neonatal alloimmune thrombocytopenia (NAIT) occurs when maternal alloantibodies react to antigens expressed on fetal platelets, which is mainly platelet-specific alloantigen or HLA, resulting in their immune destruction. Here, we described a patient who suffered from NAIT caused by anti-HLA-A2 antibody. Sera from the mother and the newborn were screened for human platelet antigen-specific antibodies and HLA antibodies by ELISA, and HLA antibodies were detected in both of them. The antibody specificity was identified as anti-HLA-A2 by Luminex single antigen bead assay. HLA typing results showed that patient's father descended HLA-A2 antigen on the patient and the mother was HLA-A2 negative. It is most conceivable that anti-HLA-A2 alloantibody in the mother's sera crossed the placenta and subsequently caused NAIT in the case presented. The patient received platelet concentrates, oral steroid and intravenous globulin and platelet count increased to 120×10⁹/L on the 90th day of life. The Luminex single antigen bead assay used in this case is highly sensitive and specific assay to determine antibody specificity and it is faster and more convenient for routine use in clinical laboratory so that this assay could be useful to diagnose NAIT caused by HLA antibodies and treat such NAIT patients with HLA matched platelet transfusion.

Keywords: Neonatal alloimmune thrombocytopenia (NAIT), Anti-HLA-A2 antibody, Luminex single antigen bead assay

Figures and Tables

Fig. 1

Platelet count after birth. Arrows indicate platelet transfusion.

Notes

This article is available from http://www.labmedonline.org

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