CAJ | 학술논문

目的探讨抗血小板特异性抗原(HPA)-3a抗体所致新生儿同种免疫性血小板减少性紫癜(NAITP)的诊断和治疗.方法采用多重PCR及基因测序技术检测1例出血伴血小板减少新生儿及其父母HPA-1~21bw系统基因型,采用流式细胞术(FCM)和血小板抗原单克隆抗体特异性免疫固定检测技术(MAIPA)检测患儿及其母亲血清血小板特异性抗体并进行特异性鉴定.结果患儿出生后2 h出现全身多发皮下出血点、血尿及咖啡色呕吐物.基因分型显示患儿为HPA-3ab、母亲为HPA-3bb、父亲为HPA-3aa;患儿及母亲血清中均含与患儿父亲血小板反应的特异性抗体,经MAIPA技术鉴定为抗HPA-3a抗体.结论发现1例抗HPA-3a抗体所致NAITP患者,通过临床特征分析为该病的诊断和治疗提供借鉴与参考.
목적 탐토항혈소판특이성항원(HPA)-3a항체소치신생인동충면역성혈소판감소성자전(NAITP)적진단화치료.방법 채용다중PCR급기인측서기술검측1례출혈반혈소판감소신생인급기부모HPA-1~21bw계통기인형,채용류식세포술(FCM)화혈소판항원단극륭항체특이성면역고정검측기술(MAIPA)검측환인급기모친혈청혈소판특이성항체병진행특이성감정.결과 환인출생후2 h출현전신다발피하출혈점、혈뇨급가배색구토물.기인분형현시환인위HPA-3ab、모친위HPA-3bb、부친위HPA-3aa;환인급모친혈청중균함여환인부친혈소판반응적특이성항체,경MAIPA기술감정위항HPA-3a항체.결론 발현1례항HPA-3a항체소치NAITP환자,통과림상특정분석위해병적진단화치료제공차감여삼고.
Objective To explore the diagnosis and treatment of a case of neonatal alloimmune thrombocytopenia purpura (NAITP) caused by anti HPA-3a antibody. Methods The platelet counts and purpuric symptom in the newborn were clinical examined. The HPA-1-21bw genotypes of the newborn and his parents were detected by multiple DNA-PCR, gene sequencing and genotyping. The HPA specificity antibody in the sera of newborn and his mother were detected by flow cytometry (FCM), and the HPA specificity antibody was identified by monoclonal antibody-specific immobilization of platelet antigens (MAIPA). Results The newborn had the typical symptom of NAITP, multiple subcutaneous petechia, hematuria and coffee-like vomitus. The HPA genotype of the newborn was HPA-3ab, while that of his mother and his father were HPA-3bb and HPA-3aa, respectively. The sera of newborn and his mother existed antibody against the platelet of newborn's father. The HPA antibody of the newborn and his mother were identified as anti HPA-3a. The newborn was approved a patient of NAITP caused by anti HPA-3a antibody. Conclusion The diagnosis and treatment for NAITP newborn caused by anti HPA-3a antibody in this study was the first domestic report. It could provide successful experiences and references for the similar cases.