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| Disease found: | Fetal Alloimmune Thrombocytopenia |
| Current as of: | October 8, 2024 |
| Disease Overview: | Maternal-fetal incompatibility leads to maternal antibodies forming against and attacking paternal antigens on fetal/neonatal platelets, resulting in platelet destruction and thrombocytopenia which can be severe [more]. |
| Signs and Symptoms: | Severity varies; babies may be asymptomatic, have skin purpura and petechiae, or sustain massive GI bleeds and intracranial hemorrhage [more]. Severity of thrombocytopenia does NOT always correlate with risk of bleed. |
| Diagnosis: | Commonly not diagnosed until symptoms are seen post-birth unless there is a known family history of FNAIT in older siblings. HPA genotyping of mother, father, and newborn and analysis of maternal blood for anti-HPA antibody presence can establish the diagnosis [more]. |
| Treatment: | Symptomatic FNAIT in a newborn can be managed with platelet transfusion, ideally HPA-selected [more]; most newborns will do well unless they sustain ICH. If there is family history of FNAIT in siblings, IVIG and steroids may be given to the pregnant mother beginning at 16 weeks’ gestation to reduce the risk of FNAIT occurring in the next child [more]. |
| Clinical Management: | Early delivery with C-section may lower risk of ICH in a fetus with FNAIT. Newborns with FNAIT should receive a cranial ultrasound to assess for ICH. [more] |
| Referral: | Families should be referred to maternal-fetal medicine and hematology specialists. AlloHope patient organization maintains a list of recommended maternal-fetal medicine specialists for FNAIT. Referral to Medical Genetics Department, if available. Initial virtual care is also available through organizations like TeleRare Health. |
| Clinical Trials: | Two studies are currently recruiting, one in the USA and one in Europe. |