Alloimmune thrombocytopenia is an interesting and challenging disease. Identification
in the fetus and newborn by screening remains to be clarified. The primary clinical
criterion for neonatal diagnosis appears to be a neonatal platelet count of <50 ×
10 9
/L. Treatment of the neonate can be accomplished with intravenous immunoglobulin (IVIG)
± steroids or with matched platelet transfusion. Cranial ultrasonography is important.
Testing can be performed on the parents and requires a highly experienced laboratory.
If an affected fetus is identified, based on a previous affected neonate and a homozygous
father, antenatal management is needed. Studies have been completed that inform the
still controversial decision. IVIG remains the basis of therapy but appears to require
a higher dose (2 g/kg/week) and/or the addition of 1 mg/kg of prednisone in the highest
risk cases, those with antenatal intracranial hemorrhage.
Alloimmune thrombocytopenia - platelets - fetal hematology - intravenous gamma globulin
- neonatal thrombocytopenia
