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A combined effect of anti-HPA-1a and anti-HLA Class I in pregnancy?

Permanent link
https://hdl.handle.net/10037/22783
DOI
https://doi.org/10.1111/trf.15944
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Date
2020-06-30
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Dahl, Jesper; Skogen, Bjørn; Kjær, Mette; Husebekk, Anne; Kjeldsen-Kragh, Jens; Tiller, Heidi
Abstract
Background - Maternal anti–human leukocyte antigen (HLA) Class I is commonly detected alongside anti–human platelet antigen (HPA)-1a in fetal and neonatal alloimmune thrombocytopenia (FNAIT). Little is known regarding whether the presence of anti-HLA Class I may exert an additive effect on the risk and severity of FNAIT.

Methods and Materials - We reanalyzed samples originally collected as part of a large Norwegian screening study on FNAIT during 1995-2004. This study identified and managed 170 pregnancies where the mother was HPA-1a negative and had detectable anti-HPA-1a during pregnancy. Maternal samples from 166 of these pregnancies were rescreened for anti-HLA Class I, revealing 111 (67%) that were antibody positive. Various regression models were used to assess if and how maternal anti-HLA Class I influenced the neonatal platelet count.

Results and Conclusions - Unadjusted neonatal platelet counts and the frequency of neonatal thrombocytopenia was not significantly affected by the presence of anti-HLA Class I alongside anti–HPA-1a, but results from regression analyses revealed a possible increased risk when the mother was nulliparous. These results warrant further investigation.
Publisher
Wiley
Citation
Dahl, Skogen, Kjær, Husebekk, Kjeldsen-Kragh, Tiller. A combined effect of anti-HPA-1a and anti-HLA Class I in pregnancy?. Transfusion. 2020;60(9):2121-2129
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