Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Refsum E 1 , Mörtberg A 2 , Dahl J 3 , Meinke S 4 , Auvinen MK 2 , Westgren M 5 Show all authors , Reilly M 6 , Höglund P 2 , Wikman A 1

Affiliations 

  • 1 Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
  • 2 Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
  • 3 Department of Medical Biology, Immunology Research Group, Arctic University of Norway, Tromso, Norway
  • 4 Department of Medicine Huddinge, Center for Hematology and Regenerative Medicine (HERM), Karolinska Institutet, Stockholm, Sweden
  • 5 Department of Obstetrics and Gynaecology, Karolinska University Hospital, Stockholm, Sweden
  • 6 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Transfus Med, 2017 Feb;27(1):43-51.
PMID: 27862486 DOI: 10.1111/tme.12375

Abstract

OBJECTIVES: To investigate the specificities and level of HLA class I antibodies in selected cases referred for suspected foetal and neonatal alloimmune thrombocytopenia (FNAIT).

BACKGROUND: FNAIT occurs in 1 : 1-2000 live births, whereas maternal immunisation against human leukocyte antigen (HLA) class I is common. Whether HLA class I antibodies alone can cause FNAIT is debatable.

MATERIAL AND METHODS: A total of 260 patient samples were referred between 2007 and 2012. Referrals with maternal HLA class I antibodies and no other cause for the neonatal thrombocytopenia were included for analysis (cases, n = 23). HPA-1a negative mothers were excluded. Control groups were screened positive mothers of healthy neonates (controls, n = 33) and female blood donors (blood donors, n = 19). LABScreen single antigen HLA class I beads was used for antibody analysis. Clinical records were reviewed for cases.

RESULTS: All groups had broad antibody reactivity. Cases had more antibodies with high SFI levels compared with the controls (SFI>9999; medians 26, 6 and 0; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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