A recent case report published in the Asian Journal of Transfusion Science found that a set of simple and noninvasive techniques can be used to diagnose fetal and neonatal alloimmune thrombocytopenia (FNAIT) by identifying platelet antibodies.
A variety of tests are available to diagnose patients with FNAIT. Among these is the monoclonal antibody immobilization of platelet antigens (MAIPA) test, often considered the gold standard for diagnosis. However, in some countries, the MAIPA test is not readily available, requiring physicians to find alternative options.
The case report describes a male who was born at 37 weeks and six days gestation with jitteriness and difficultly feeding, as well as port-wine stains covering his body. Laboratory testing suggested thrombocytopenia.
The patient underwent a series of tests to rule out various conditions including immune thrombocytopenia purpura (ITP) and gestational thrombocytopenia. The physicians also performed a panel to test for autoimmune diseases with no findings.
Read more about FNAIT testing and diagnosis
Next, blood samples of the mother and father were taken and a platelet crossmatch test was performed. This showed that the mother’s blood was incompatible with the father’s platelets, confirming the presence of maternal antibodies. An antibody screen identified these antibodies as anti-human platelet antigen (HPA)-15a.
The authors then sent samples from both parents and the baby for genotyping, which revealed that both the baby and father expressed HPA-15a on their platelets, while the mother only expressed HPA-15b. Based on these findings and the presence of thrombocytopenia, the authors confirmed a diagnosis of FNAIT.
The patient was prescribed a platelet transfusion, intravenous immunoglobulin and corticosteroids. He responded well to this treatment regimen, and his platelet counts soon began to rise to normal levels.
“Laboratory expertise with platelet immunobiology to establish diseases such as [FNAIT] is the need of the hour,” the authors concluded. “A diagnostic test is essential for early diagnosis and prompt management.”
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