Successful management of a hydropic fetus with severe anemia and thrombocytopenia caused by anti-CD36 antibody.
Int J Hematol
; 107(2): 251-256, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-28815406
ABSTRACT
Cases of CD36 deficiency are not rare in Asian populations, foetal and neonatal alloimmune thrombocytopenia (FNAIT) caused by anti-CD36 isoantibodies appears more frequent than other HPA alloantibodies. However, little is known about the treatment of anti-CD36 mediated FNAIT in this region. A Chinese male foetus, whose mother had a history of multiple intrauterine foetal demise and/or hydrops, was diagnosed with severe FNAIT at 27 weeks of gestational age. Immunological analysis revealed total absence of CD36 on platelets and monocytes from mother, caused by a 329-330delAC mutation of the CD36 gene. Anti-CD36 and anti-HLA class I antibodies were detected in the maternal serum, whereas only anti-CD36 isoantibodies were detectable in the foetal blood sample. Serial intrauterine transfusions with red blood cells (RBC) and platelets from a CD36null donor were performed to improve the severe anaemia and thrombocytopenia. The baby (2250 g; Apgar scores 10) was delivered vaginally at 32 weeks of gestation with normal haemoglobin (186 g/L) but low platelet count (48 × 109/L). After 2 days the platelet count rose to 121 × 109/L. This report suggests that intrauterine transfusions with compatible RBC and CD36null platelets are useful in preventing the deleterious clinical effects of anti-CD36-mediated severe FNAIT.
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MEDLINE
Assunto principal:
Transfusão de Sangue Intrauterina
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Hidropisia Fetal
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Transfusão de Plaquetas
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Transfusão de Eritrócitos
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Antígenos CD36
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Trombocitopenia Neonatal Aloimune
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Doenças Fetais
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Anemia
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Anticorpos
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article