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Archives de pédiatrie
Volume 26, n° 3
pages 191-197 (avril 2019)
Doi : 10.1016/j.arcped.2019.02.006
Received : 11 October 2018 ;  accepted : 3 February 2019
Practice Guidelines

Management of neonatal thrombocytopenia in a context of maternal antiplatelet alloimmunization: Expert opinion of the French-speaking working group
 

G. Bertrand a, , L. Blouin b, F. Boehlen c, E. Levine d, J.-M. Minon e, N. Winer f
On behalf of the

working group on fetomaternal platelet alloimmunization of the French Group of Thrombosis, Hemostasis (GFHT)1

  On behalf of the French-speaking expert panel (addresses are in France unless otherwise stated): Marie AUDRAIN (Service d’immunologie, CHU, Nantes); Sophie BAYART (Hématologie pédiatrique, CRTH, CHU, Rennes); Mathilde BEGUET (EFS Nouvelle Aquitaine, Bordeaux); Philippe BIERLING (EFS Île-de-France, Ivry-sur-Seine); Valérie CHABOT (Laboratoire HLA, EFS Centre Atlantique, Tours); Anne CORTEY (Unité fonctionnelle clinique du Centre National de Référence en Hémobiologie Périnatale, Service de médecine fœtale, Hôpital Trousseau, Paris); Laure CROISILLE (Laboratoire HLA-ILP - EFS Ile-de-France, Créteil); Fanny DELETTRE (EFS Bourgogne Franche-Comté, Besançon); Arnaud DUPUIS (EFS Grand Est-Strasbourg); Mathilde FRETIGNY (Laboratoire de Biologie Moléculaire, Groupement Hospitalier Est, Lyon); Catherine GIANNOLI (EFS Auvergne-Rhône-Alpes, Lyon); Valérie GOUA (Service de gynécologie et obstétrique, CHU, Poitiers); Yves GRUEL (Service d’Hématologie-Hémostase, CHRU, Tours); Annie HARROCHE (Service d’Hématologie Clinique, Centre de Traitement de l’Hémophilie, Hôpital Necker, Paris); Marie-Françoise HURTAUD (Hématologie biologique, Hôpital Robert Debré, Paris); Jean-Marie JOUANNIC (Service de médecine fœtale, Hôpital Trousseau, Paris); Xavier LAFARGE (EFS Nouvelle Aquitaine, Bordeaux); Emilie LE TORIELLEC (Laboratoire HLA-ILP, EFS Ile-de-France, Créteil);Thomas LECOMPTE (HUG, Geneva, Switzerland); Laurent MACCHI (Service d’hématologie biologique, Poitiers); Caroline MAKOWSKI (Hématologie, CHU Grenoble Alpes, Grenoble); Veneranda MATTIELLO (Unité d’onco-hématologie pédiatrique, HUG, Geneva, Switzerland); Yves MERIEUX (EFS Auvergne-Rhône-Alpes, Lyon); Guillaume MOUREY (EFS Bourgogne Franche-Comté, Besançon); Brigitte PAN-PETESCH (Unité Hémostase CRTH, CHU Morvan, Brest); Gianmaria PELLEGRINELLI (Service de gynécologie et d’obstétrique, HUG, Geneva, Switzerland); Rachel PETERMANN (INTS, Paris);Edith PEYNAUD-DEBAYLE (Hématologie Biologique & Transfusion, Paris Nord Val de Seine, Colombes);Christophe PICARD (Laboratoire HLA, EFS PACA-Corse, Marseille);Virginie RENAC (laboratoire HLA-HPA, EFS Bretagne, Rennes); Jonathan ROSENBLATT (Service Gynécologie Obstétrique, Hôpital Robert Debré, Paris); Lucia RUGERI (Unité d’Hémostase Clinique, Groupement Hospitalier Est, Lyon); Rita TURELLO (Onco-hématologie pédiatrique, CHUV, Lausanne, Switzerland). External validation by: Professor Elie SALIBA (on behalf of the French Society of Neonatology, SFN); Professor Marlène PASQUET (on behalf of the French Society of Pediatric Hematology and Immunology, SHIP).

a laboratoire HLA-HPA, Établissement français du sang (EFS) Bretagne, rue Pierre-Jean-Gineste, BP 91614, 35016 Rennes cedex, France 
b Laboratoire d’immunologie et immunogénétique, EFS Nouvelle Aquitaine, CHU de Bordeaux, place Amélie-Léon, 33076 Bordeaux cedex, France 
c Service d’angiologie et d’hémostase, hôpitaux universitaires de Genève, 4, rue Gabrielle-Perret-Gentil, 1211 Genève 14, Switzerland 
d Service de néonatologie soins intensifs, hôpital universitaire de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France 
e Unité d’hémostase et de transfusion, département de médecine de laboratoire, centre hospitalier régional de la Citadelle, boulevard du XXIIe-de-Ligne, 4000 Liège, Belgium 
f INRA, UMR 1280, département de gynécologie et d’obstétrique, physiologie des adaptations nutritionnelles, hôpital universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France 

Corresponding author at: laboratoire HLA-HPA, Établissement français du sang (EFS) Bretagne, rue Pierre-Jean-Gineste, BP 91614, 35016 Rennes cedex, France.laboratoire HLA-HPA, Établissement français du sang (EFS) Bretagnerue Pierre-Jean-Gineste, BP 91614Rennes cedex35016France
Abstract

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a potentially devastating disease, seen in 1/800–1000 neonates. FNAIT is the most common cause of early-onset isolated severe neonatal thrombocytopenia in maternity wards. The most feared complication of this disorder is intracranial hemorrhage, leading to death or neurological sequelae. There is no systematic screening of at-risk pregnancies and FNAIT is often discovered when fetal or neonatal bleeding is observed. A working group on fetomaternal platelet alloimmunization was created in 2017, under the auspices on the French Group of Thrombosis and Hemostasis (GFHT). The first objective of this group was to survey clinical practices for treatment of thrombocytopenic neonates in a context of suspected or confirmed FNAIT.

The full text of this article is available in PDF format.

Keywords : Newborn, Neonatal thrombocytopenia, Platelet, Alloimmunization, Transfusion, Human platelet antigen (HPA)


1  On behalf of the French-speaking expert panel (addresses are in France unless otherwise stated): Marie AUDRAIN (Service d’immunologie, CHU, Nantes); Sophie BAYART (Hématologie pédiatrique, CRTH, CHU, Rennes); Mathilde BEGUET (EFS Nouvelle Aquitaine, Bordeaux); Philippe BIERLING (EFS Île-de-France, Ivry-sur-Seine); Valérie CHABOT (Laboratoire HLA, EFS Centre Atlantique, Tours); Anne CORTEY (Unité fonctionnelle clinique du Centre National de Référence en Hémobiologie Périnatale, Service de médecine fœtale, Hôpital Trousseau, Paris); Laure CROISILLE (Laboratoire HLA-ILP - EFS Ile-de-France, Créteil); Fanny DELETTRE (EFS Bourgogne Franche-Comté, Besançon); Arnaud DUPUIS (EFS Grand Est-Strasbourg); Mathilde FRETIGNY (Laboratoire de Biologie Moléculaire, Groupement Hospitalier Est, Lyon); Catherine GIANNOLI (EFS Auvergne-Rhône-Alpes, Lyon); Valérie GOUA (Service de gynécologie et obstétrique, CHU, Poitiers); Yves GRUEL (Service d’Hématologie-Hémostase, CHRU, Tours); Annie HARROCHE (Service d’Hématologie Clinique, Centre de Traitement de l’Hémophilie, Hôpital Necker, Paris); Marie-Françoise HURTAUD (Hématologie biologique, Hôpital Robert Debré, Paris); Jean-Marie JOUANNIC (Service de médecine fœtale, Hôpital Trousseau, Paris); Xavier LAFARGE (EFS Nouvelle Aquitaine, Bordeaux); Emilie LE TORIELLEC (Laboratoire HLA-ILP, EFS Ile-de-France, Créteil);Thomas LECOMPTE (HUG, Geneva, Switzerland); Laurent MACCHI (Service d’hématologie biologique, Poitiers); Caroline MAKOWSKI (Hématologie, CHU Grenoble Alpes, Grenoble); Veneranda MATTIELLO (Unité d’onco-hématologie pédiatrique, HUG, Geneva, Switzerland); Yves MERIEUX (EFS Auvergne-Rhône-Alpes, Lyon); Guillaume MOUREY (EFS Bourgogne Franche-Comté, Besançon); Brigitte PAN-PETESCH (Unité Hémostase CRTH, CHU Morvan, Brest); Gianmaria PELLEGRINELLI (Service de gynécologie et d’obstétrique, HUG, Geneva, Switzerland); Rachel PETERMANN (INTS, Paris);Edith PEYNAUD-DEBAYLE (Hématologie Biologique & Transfusion, Paris Nord Val de Seine, Colombes);Christophe PICARD (Laboratoire HLA, EFS PACA-Corse, Marseille);Virginie RENAC (laboratoire HLA-HPA, EFS Bretagne, Rennes); Jonathan ROSENBLATT (Service Gynécologie Obstétrique, Hôpital Robert Debré, Paris); Lucia RUGERI (Unité d’Hémostase Clinique, Groupement Hospitalier Est, Lyon); Rita TURELLO (Onco-hématologie pédiatrique, CHUV, Lausanne, Switzerland). External validation by: Professor Elie SALIBA (on behalf of the French Society of Neonatology, SFN); Professor Marlène PASQUET (on behalf of the French Society of Pediatric Hematology and Immunology, SHIP).


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