[The methods of diagnostic of immune thrombocytopenia of fetus and newborn]. 2016

E V Butina, and G A Zaitseva

The thrombocytopenia is found in 1%-5% of newborns. Depending on mechanisms of pathogenesis of thrombocytopenia is divided on immune and non-immune one. The reaction of of interaction between antibodies and antigens of superficial structures of cells are in the basis of immune destruction of thrombocytes. During intrauterine period and period of newborness auto-, trans- and alloimmune alternatives of development of thrombocytopenia can be observed. The neonatal alloimmune thrombocytopenia is registered with rate of 1 case per 800-1000 newborns. The study was targeted to developing algorithm of diagnostic of immune thrombocytopenia, detecting main diagnostic criteria, exploring clinical significance of results of laboratory tests. The methods of study included typing of genes of HPA system using polymerase chain reaction with detection of results in real-time mode, detection of compatibility of HPA-genotypes of mother and child using flow cytometry technique. The following criteria of diagnostic of neonatal alloimmune thrombocytopenia: 1. detection of incompatible combination of HPA genes in mother and child (HPA-1bb/HPA-1ab; HPA-5aa/HPA-5ab; HPA-15ab/HPA- 15ab); 2. detection in blood serum of mother antibodies adsorbing more than on 3% of thrombocytes of child; 3. absence of antithrombocyte antibodies in mother and child (coefficient of auto-sensitization is less than 5%). The immune genesis of thrombocytopenia is established in 40% 0f children with low number of thrombocytes at birth. In 50% of cases the cause was determined as anti-thrombocyte alloantibodies with diagnosis neonatal alloimmune thrombocytopenia. Also in 50% of cases decreasing of number of thrombocytes in children occurred as result of impact of autoantibodies of mother with diagnosis “transimmune thrombocytopenia”. The considered laboratory methods have high specificity and permit to properly diagnose immune causes of thrombocytopenia in newborns.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D001792 Blood Platelets Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. Platelets,Thrombocytes,Blood Platelet,Platelet,Platelet, Blood,Platelets, Blood,Thrombocyte
D005260 Female Females
D005838 Genotype The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS. Genogroup,Genogroups,Genotypes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001323 Autoantibodies Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them. Autoantibody
D016824 Antigens, Human Platelet Human alloantigens expressed only on platelets, specifically on platelet membrane glycoproteins. These platelet-specific antigens are immunogenic and can result in pathological reactions to transfusion therapy. Antigens, Platelet-Specific,Human Platelet Antigen,Human Platelet Antigens,Platelet Alloantigen,Platelet Alloantigens,Platelet-Specific Antigen,Platelet-Specific Antigens,Alloantigen, Platelet,Alloantigens, Platelet,Antigen, Human Platelet,Antigen, Platelet-Specific,Antigens, Platelet Specific,Platelet Antigen, Human,Platelet Antigens, Human,Platelet Specific Antigen,Platelet Specific Antigens
D054098 Thrombocytopenia, Neonatal Alloimmune A condition in newborns caused by immunity of the mother to PLATELET ALLOANTIGENS on the fetal platelets. The PLATELETS, coated with maternal ANTIBODIES, are destroyed and removed by the fetal MONONUCLEAR PHAGOCYTE SYSTEM. Affected infants may have INTRACRANIAL HEMORRHAGES. Neonatal Alloimmune Thrombocytopenia,Neonatal Thrombocytopenia,Alloimmune Thrombocytopenia, Neonatal,Alloimmune Thrombocytopenias, Neonatal,Neonatal Alloimmune Thrombocytopenias,Neonatal Thrombocytopenias,Thrombocytopenia, Neonatal,Thrombocytopenias, Neonatal,Thrombocytopenias, Neonatal Alloimmune
D033261 Maternal-Fetal Relations The bond or lack thereof between a pregnant woman and her FETUS. Mother-Fetus Relationship,Mother-Fetus Relations,Maternal Fetal Relations,Mother Fetus Relations,Mother Fetus Relationship,Mother-Fetus Relationships,Relations, Maternal-Fetal,Relations, Mother-Fetus,Relationship, Mother-Fetus,Relationships, Mother-Fetus

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