Pregnancy-associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype

Br J Haematol. 1999 Mar;104(4):878-85. doi: 10.1046/j.1365-2141.1999.01270.x.

Abstract

In a prospective study between 1993 and 1998, data was collected from 46 pregnant women and subsequently from their babies. 25 pregnant women with active autoimmune thrombocytopenic purpura (AITP) or a history of AITP (group A) and 21 pregnant women with isolated thrombocytopenia and identification of specific platelet autoantibodies detected by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay (group B) were evaluated for platelet-associated immunoglobulin-G (PAIgG), MAIPA assay and HLA genotype. Neonatal platelet counts were performed at least three times in the first week. 11 neonates were thrombocytopenic (23.9%). No severe haemorrhage occurred. There were no significant differences regarding the values of PAIgG or positive MAIPA tests between mothers of thrombocytopenic or healthy newborns. A significant difference, however, regarding the HLA DRB3* allele was found, with a high incidence in the subgroup of mothers of healthy newborns (P = 0.005). A similar trend was found among mothers with anti-GPIIbIIIa antibodies (P = 0.06). In contrast, HLA DRB5* allele appeared to be present especially in mothers of thrombocytopenic newborns (not significant). Our data suggest that mothers with AITP who have the HLA DRB3* genotype are unlikely to give birth to a thrombocytopenic baby. This study provides a preliminary report on a noninvasive test to identify infants who are likely to be affected.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoantibodies / analysis
  • Autoimmune Diseases / genetics*
  • Blood Platelets / immunology
  • Female
  • HLA Antigens / genetics*
  • Humans
  • Immunoassay
  • Infant, Newborn
  • Male
  • Platelet Count
  • Platelet Glycoprotein GPIIb-IIIa Complex / metabolism
  • Pregnancy
  • Pregnancy Complications, Hematologic / immunology*
  • Prospective Studies
  • Thrombocytopenia / genetics*
  • Thrombocytopenia / immunology

Substances

  • Autoantibodies
  • HLA Antigens
  • Platelet Glycoprotein GPIIb-IIIa Complex