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抗HPA-3a抗体所致新生儿同种免疫性血小板减少性紫癜一例并文献复习
(来源:南宁输血医学研究所 )

作者:周燕  钟周琳  李丽兰  申卫东  刘金莲  吴国光
来源:中华血液学杂志,2013,34(1):44-48.

【摘要】  目的  探讨抗血小板特异性抗原(HPA)-3a抗体所致新生儿同种免疫性血小板减少性紫癜(NAITP)的诊断和治疗。方法  采用多重PCR及基因测序技术检测1例出血伴血小板减少新生儿及其父母HPA-1~21bw系统基因型,采用流式细胞术(FCM)和血小板抗原单克隆抗体特异性免疫固定检测技术(MAIPA)检测患儿及其母亲血清血小板特异性抗体并进行特异性鉴定。结果  患儿出生后2 h出现全身多发皮下出血点、血尿及咖啡色呕吐物。基因分析显示患儿为HPA-3ab,母亲为HPA-3bb,父亲为HPA-3aa;患儿及母亲血清中均含与患儿父亲血小板反应的特异性抗体,经MAIPA技术鉴定为抗HPA-3a抗体。结论  发现1例抗HPA-3a抗体所致NAITP患者,通过临床特征分析为该病的诊断和治疗提供借鉴和参考。
【关键词】 血小板减少,新生儿同种免疫性性;流式细胞术;抗原,人血小板;聚合酶链反应
 
Diagnosis and treatment of a case of neonatal alloimmune thrombocytopenia purpura caused by anti HPA-3a antibody and literature review  

ZHOU Yan, ZHONG Zhou-lin, LI- Lilan, SHEN Wei-dong, LIU Jin-lian, WU Guo-guang. 
CHINESE JOURNAL OF HEMATOLOGY, 2013,34(1):44-48.

【Abstract】  Objective To study the diagnosis and treatment of a case of neonatal alloimmune thrombocytopenia purpura (NAITP) which caused by anti HPA-3a antibody. Methods  The HPA-1-21bw genotypes of the newborn and his parents were detected by multiple DNA-PCR and Gene sequencing genotyping. The HPA specificity antibody in the sera of newborn and his mother were detected by Flow CytoMetry (FCM), and the HPA specificity antibody was identified by Monoclonal Antibody-specific Immobilization of Platelet Antigens (MAIPA). Results The newborn emerged subcutaneous hemorrhage, cruenturesis, brown vomitus when he was 2 hours old. The HPA genotype of the newborn was HPA-3ab, while that of his mother and father were HPA-3bb and HPA-3aa, respectively .The sera of newborn and his mother existed antibody against the platelet of newborn’s father. The HPA antibody of the newborn and his mother were identified as anti HPA-3a. The newborn was approved a patient of NAITP caused by anti HPA-3a antibody. Conclusion  The diagnosis and treatment for NAITP newborn caused by anti HPA-3a antibody in this study was the first domestic report. It could provide successful experiences and references for the clinical similar cases.

【Key words】  Thrombocytopenia, Neonatal Alloimmune;Flow Cytometry; Antigens, Human Platelet;Polymerase Chain Reaction


时间: 2015 年 09 月 15 日
           
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