AJP Rep 2013; 03(01): 041-044
DOI: 10.1055/s-0032-1331379
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Case of Alloimmune Thrombocytopenia, Hemorrhagic Anemia-Induced Fetal Hydrops, Maternal Mirror Syndrome, and Human Chorionic Gonadotropin–Induced Thyrotoxicosis

Venu Jain
1  Division of Maternal-Fetal Medicine Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Gwen Clarke
2  Department of Pathology and Laboratory Medicine, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Laurie Russell
2  Department of Pathology and Laboratory Medicine, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Angela McBrien
3  Division of Pediatric Cardiology/Fetal and Neonatal Cardiology Program, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Lisa Hornberger
3  Division of Pediatric Cardiology/Fetal and Neonatal Cardiology Program, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Carmen Young
1  Division of Maternal-Fetal Medicine Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
,
Sujata Chandra
1  Division of Maternal-Fetal Medicine Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
› Author Affiliations
Further Information

Publication History

08 August 2012

11 August 2012

Publication Date:
25 January 2013 (eFirst)

  

Abstract

Fetal/neonatal alloimmune thrombocytopenia (FNAIT) can be a cause of severe fetal thrombocytopenia, with the common presentation being intracranial hemorrhage in the fetus, usually in the third trimester. A very unusual case of fetal anemia progressed to hydrops. This was further complicated by maternal Mirror syndrome and human chorionic gonadotropin–induced thyrotoxicosis. Without knowledge of etiology, and possibly due to associated cardiac dysfunction, fetal transfusion resulted in fetal demise. Subsequent testing revealed FNAIT as the cause of severe hemorrhagic anemia. In cases with fetal anemia without presence of red blood cell antibodies, FNAIT must be ruled out as a cause prior to performing fetal transfusion. Fetal heart may adapt differently to acute hemorrhagic anemia compared with a more subacute hemolytic anemia.

Note

Presented at the 11th World Congress in Fetal Medicine, Kos, Greece, June 24 to 28, 2012.