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Archives de pédiatrie
Volume 14, n° 9
pages 1094-1096 (septembre 2007)
Doi : 10.1016/j.arcped.2007.05.008
Received : 3 Mars 2006 ;  accepted : 11 May 2007
Traitement par immunoglobulines intraveineuses dans 2 cas d'allo-immunisation foetomaternelle plaquettaire HPA-5b avec antécédents sévères
Intravenous human immunoglobulin treatment in 2 feto-maternal platelet HPA-5b alloimmunization with severe previous history
 

P. Moncharmont , M. Vignal, Y. Merieux, D. Rigal
Établissement français du sang, Rhône-Alpes, site de Lyon-Gerland, 1-3, rue du Vercors, 69364 Lyon cedex 07, France 

Auteur correspondant.
Résumé

La thrombopénie foetale et néonatale due à une allo-immunisation plaquettaire maternelle anti-HPA-5b reste généralement d'expression clinique modérée par rapport à l'allo-immunisation anti-HPA-1a. Néanmoins, 1 cas d'hémorragie intracrânienne létale probablement liée à une allo-immunisation anti-HPA-5b a été rapporté. Le traitement par immunoglobulines intraveineuses des mères présentant une allo-immunisation antiplaquettaire spécifique et des antécédents sévères durant une grossesse ultérieure avec incompatibilité plaquettaire foetomaternelle permet d'éviter la thrombopénie chez un foetus et un nouveau-né hétérozygote. Deux cas de patientes allo-immunisées anti-HPA-5b et comportant des antécédents sévères, de mort foetale ou d'hémorragie intracrânienne foetale, et traitées avec succès par immunoglobulines intraveineuses seules durant une seconde grossesse avec incompatibilité foetomaternelle sont présentés.

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

Fetal and neonatal alloimmune thrombocytopenia due to mothers' anti-HPA-5b alloimmunization has generally a milder clinical presentation compared to anti-HPA-1a alloimmunization. Nevertheless, a case with infant's death probably due to intracranial haemorrhage has been reported. However, if platelet-specific alloimmunized mothers with prior fetal or neonate injury receive intravenous immunoglobulins during pregnancy, thrombocytopenia in heterozygous fetus and neonate may be prevented. Here are reported 2 cases of anti-HPA-5b fetal-maternal alloimmunization, one with prior fetal death, the other with prior severe fetal intracranial haemorrhage, which were successfully treated with intraveinous immunoglobulins alone during a second pregnancy with HPA-5b incompatibility.

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

Mots clés : Plaquettes, Allo-immunisation, Incompatibilité foetomaternelle




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