Fetal and neonatal alloimmune thrombocytopenia (FNAIT)FFetal and neonatal alloimmune thrombocytopenia (FNAIT)Fetal and neonatal alloimmune thrombocytopenia (FNAIT)EnglishHaematologyNewborn (0-28 days);PrenatalNACardiovascular systemConditions and diseasesAdult (19+) CaregiversNA2017-11-09T05:00:00ZLani Lieberman, MD, FRCPC;Mark Fung, MD, PhD;Nadine Shehata, MD, MSc, FRCPC;Stacy Corke9.0000000000000056.1000000000000910.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out about fetal and neonatal alloimmune thrombocytopenia (FNAIT) including its causes, symptoms, diagnosis, prevention and treatment. <br></p><h2>What is FNAIT?</h2><p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when the mother’s immune system attacks her fetus’ or newborn’s platelets. Platelets are a type of blood cell that have proteins on their surface and are involved in blood clotting. If a fetus or newborn has a low platelet count then they will have an increased risk of bleeding. In most cases the effects of FNAIT are mild, however, if bleeding occurs in the brain, there may be long-term effects.</p><h3>Other names for FNAIT</h3><p>FNAIT is also called NAIT, AIT, FMAIT (fetal maternal alloimmune thrombocytopenia), NAT or NATP (neonatal alloimmune thrombocytopenic purpura).</p><h2>Key points</h2><ul><li>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when the mother’s immune system attacks her fetus’ and/or newborn’s platelets, the blood cells that help stop bleeding.</li><li>Doctors may suspect a baby has FNAIT if there is bruising, bleeding, a specific pinpoint rash and/or a low platelet count on a blood test.</li><li>The main treatment for a baby with FNAIT is platelet transfusions.</li><li>If the mother becomes pregnant again in the future, her doctor should refer her to a hospital that specializes in fetal-maternal medicine for monitoring and treatment.</li></ul><h2>Why does FNAIT happen?</h2><p>Platelets have many proteins on their surface. Each person has a different set of proteins, which are inherited from their parents. Sometimes a baby inherits a protein that is found on their father’s platelets but is absent from their mother’s platelets. When this happens the mother's immune system may respond by developing an antibody to fight against the protein the baby inherited from their father. This is called an alloimmune response.</p><p>The antibody may pass from the mother’s blood into the baby’s blood through the placenta and attach to the baby’s platelets. This antibody destroys the baby’s platelets, resulting in a low platelet count and an increased risk of bleeding for the baby.</p><p>The mother’s antibodies can remain in the baby’s blood stream for weeks, and bleeding can occur in the baby before birth (fetal), during birth or after birth (neonatal).</p><p>There are a number of proteins that can cause FNAIT but the most common one is human platelet antigen (HPA)-1a.</p><p>FNAIT does not occur because of anything the mother does, eats or drinks. It has not been linked to any environmental or dietary exposures.</p><h3>How common is FNAIT?</h3><p>FNAIT is rare. It occurs in about one in every 2,000 births.</p><h2>How is FNAIT diagnosed?</h2><p>Doctors may suspect a baby has FNAIT if there is:</p><ul><li>bleeding or bruising</li><li>a low platelet count on a blood test after birth</li><li>a specific pinpoint rash (called petechiae)</li></ul><p>The diagnosis of FNAIT can be confirmed by taking blood samples from the mother, the father and possibly the baby. If the baby’s platelet count is very low, doctors may look for possible bleeding in the brain using ultrasound.</p><h3>Why blood tests in pregnancy do not show that the baby may have FNAIT?</h3><p>Because FNAIT is rare, doctors do not usually screen for it. Doctors may first suspect a baby has FNAIT when they are born with bruises or a rash.</p><h2>How is FNAIT treated?</h2><p>Babies with FNAIT may need to be admitted to the neonatal intensive care unit for close monitoring.</p><p>The main treatment for FNAIT is platelet transfusions. These transfusions will help to prevent and treat the bleeding.</p><h2>Where can I get more information?</h2><p>Visit <a href="https://www.naitbabies.org/">www.naitbabies.org</a>.</p><p>This document was created by the International Collaboration for Transfusion Medicine Guidelines (ICTMG), a group of international transfusion experts brought together to create and promote evidence-based guidelines to optimize transfusion care. For more information, visit the website at <a href="https://www.ictmg.org/">www.ictmg.org</a>.</p>
Thrombocytopénie allo-immune fœtale ou néonatale (TAIF/N)TThrombocytopénie allo-immune fœtale ou néonatale (TAIF/N)Fetal and neonatal alloimmune thrombocytopenia (FNAIT)FrenchHaematologyNewborn (0-28 days);PrenatalNACardiovascular systemConditions and diseasesAdult (19+) CaregiversNA2017-11-09T05:00:00ZLani Lieberman, MD, FRCPC;Mark Fung, MD, PhD;Nadine Shehata, MD, MSc, FRCPC;Stacy CorkeHealth (A-Z) - ConditionsHealth A-Z<p>Apprenez-en davantage sur la thrombocytopénie allo-immune fœtale ou néonatale (TAIF/N), incluant ses causes, ses symptômes, son diagnostic, sa prévention et son traitement. <br></p><h2>Qu’est-ce qu’une TAIF/N?</h2><p>La thrombocytopénie allo-immune fœtale ou néonatale (TAIF/N) survient lorsque le système immunitaire de la mère attaque les plaquettes du fœtus ou du nouveau-né. Les plaquettes sont un type de cellules sanguines à la surface desquelles les protéines adhèrent t qui participent à la coagulation du sang. Lorsque le fœtus ou le nouveau-né possède un nombre insuffisant de plaquettes, il court un risque accru d’hémorragie. Dans la plupart des cas, les effets de la TAIF/N sont légers. Cependant, si un saignement se produit dans le cerveau, des effets à long terme sont possibles.</p><h3>Autres noms pour la TAIF/N</h3> <p>La TAIF/N est également appelée TNAF (thrombocytopénie néonatale par allo-immunisation fœtomaternelle), NAT ou NATP (purpura thrombocytopénique néonatale allo-immune).</p><h2>À retenir</h2><ul><li>La thrombocytopénie allo-immune fœtale et néonatale (TAIF/N) survient lorsque le système immunitaire de la mère attaque les plaquettes du fœtus ou du nouveau-né, les cellules sanguines qui contribuent à arrêter le saignement.</li><li>Les médecins peuvent soupçonner un bébé atteint de TAIF/N s’il présente des ecchymoses, des saignements, une éruption cutanée précise ou un faible nombre de plaquettes lors d’un test sanguin.</li><li>Le traitement principal d’un bébé atteint de TAIF/N est la transfusion de plaquettes.</li><li>Si la mère conçoit de nouveau à l’avenir, son médecin devrait la diriger vers un hôpital spécialisé en médecine fœto-maternelle pour le suivi et le traitement.</li></ul> <h2>Pourquoi la TAIF/N se produit-elle?</h2><p>Les plaquettes portent de nombreuses protéines à leur surface. Chaque personne hérite de ses parents un ensemble différent de protéines. Parfois, un bébé hérite d’une protéine qui se trouve sur les plaquettes de son père, mais qui est absente des plaquettes de sa mère. Lorsque cela se produit, le système immunitaire de la mère peut réagir en développant un anticorps pour lutter contre la protéine héritée du père. C’est ce qu’on appelle une réponse allo-immune.</p><p>L’anticorps peut passer du sang de la mère à celui du bébé à travers le placenta et s’attacher aux plaquettes du bébé. Cet anticorps détruit les plaquettes du bébé, ce qui entraîne un nombre insuffisant de plaquettes et un risque accru de saignement pour le bébé.</p><p>Les anticorps de la mère peuvent rester dans le sang du bébé pendant des semaines et des saignements peuvent survenir chez le bébé avant la naissance (fœtale), pendant la naissance ou après la naissance (néonatale).</p><p>Un certain nombre de protéines qui peuvent causer la TAIF/N, mais la plus courante est l’antigène plaquettaire humain (HPA) 1a.</p><p>La TAIF/N n’a aucune relation avec ce que la mère fait ou consomme. La maladie n’a jamais été liée à une exposition environnementale ou alimentaire.</p><h3>À quelle fréquence survient la TAIF/N?</h3> <p>La TAIF/N est rare, soit environ une naissance sur 2 000.</p><h2>Comment la TAIF/N est-elle diagnostiquée?</h2><p>Les médecins peuvent soupçonner qu’un bébé souffre de la TAIF/N s’il présente :</p><ul><li>des saignements ou des ecchymoses</li><li>un faible nombre de plaquettes lors d’un test sanguin après la naissance</li><li>une éruption ponctuelle spécifique (appelée pétéchies)</li></ul><p>Le diagnostic de la TAIF/N peut être confirmé en prélevant des échantillons de sang de la mère, du père et éventuellement du bébé. Si le nombre de plaquettes du bébé est très faible, les médecins peuvent vérifier la présence de saignements dans le cerveau à l’aide d’ultrasons.</p><h3>Pourquoi les tests sanguins pendant la grossesse n’indiquent-ils pas que le bébé pourrait avoir la TAIF/N?</h3><p>Parce que la TAIF/N est rare. Les médecins ne font généralement pas de dépistage pour la déceler. Les médecins peuvent d’abord soupçonner qu’un bébé est atteint de TAIF/N quand ils sont naissent avec des eccymoses ou une éruption cutanée.</p> <h2>Comment la TAIF/N est-elle traitée?</h2><p>Les bébés atteints de TAIF/N peuvent devoir être admis à l’unité néonatale de soins intensifs pour une surveillance étroite.</p><p>Le traitement principal de la TAIF/N est la transfusion plaquettaire. Ces transfusions aideront à prévenir et à traiter les saignements.</p> <h2>Où puis-je obtenir plus d’informations?</h2><p>Consultez le site à l’adresse <a href="https://www.naitbabies.org/">www.naitbabies.org</a> (en anglais seulement).</p><p>Ce document a été créé par International Collaboration for Transfusion Medicine Guidelines (ICTMG), un groupe d’experts en transfusion du monde entier réunis pour élaborer des consignes fondées sur des données factuelles pour la pratique de la médecine transfusionnelle. Pour plus d’informations, consultez le site Web à l’adresse <a href="https://www.ictmg.org/">www.ictmg.org</a> (en anglais seulement).</p>

 

 

Fetal and neonatal alloimmune thrombocytopenia (FNAIT)2895.00000000000Fetal and neonatal alloimmune thrombocytopenia (FNAIT)Fetal and neonatal alloimmune thrombocytopenia (FNAIT)FEnglishHaematologyNewborn (0-28 days);PrenatalNACardiovascular systemConditions and diseasesAdult (19+) CaregiversNA2017-11-09T05:00:00ZLani Lieberman, MD, FRCPC;Mark Fung, MD, PhD;Nadine Shehata, MD, MSc, FRCPC;Stacy Corke9.0000000000000056.1000000000000910.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Find out about fetal and neonatal alloimmune thrombocytopenia (FNAIT) including its causes, symptoms, diagnosis, prevention and treatment. <br></p><h2>What is FNAIT?</h2><p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when the mother’s immune system attacks her fetus’ or newborn’s platelets. Platelets are a type of blood cell that have proteins on their surface and are involved in blood clotting. If a fetus or newborn has a low platelet count then they will have an increased risk of bleeding. In most cases the effects of FNAIT are mild, however, if bleeding occurs in the brain, there may be long-term effects.</p><h3>Other names for FNAIT</h3><p>FNAIT is also called NAIT, AIT, FMAIT (fetal maternal alloimmune thrombocytopenia), NAT or NATP (neonatal alloimmune thrombocytopenic purpura).</p><h2>Key points</h2><ul><li>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when the mother’s immune system attacks her fetus’ and/or newborn’s platelets, the blood cells that help stop bleeding.</li><li>Doctors may suspect a baby has FNAIT if there is bruising, bleeding, a specific pinpoint rash and/or a low platelet count on a blood test.</li><li>The main treatment for a baby with FNAIT is platelet transfusions.</li><li>If the mother becomes pregnant again in the future, her doctor should refer her to a hospital that specializes in fetal-maternal medicine for monitoring and treatment.</li></ul><h2>Why does FNAIT happen?</h2><p>Platelets have many proteins on their surface. Each person has a different set of proteins, which are inherited from their parents. Sometimes a baby inherits a protein that is found on their father’s platelets but is absent from their mother’s platelets. When this happens the mother's immune system may respond by developing an antibody to fight against the protein the baby inherited from their father. This is called an alloimmune response.</p><p>The antibody may pass from the mother’s blood into the baby’s blood through the placenta and attach to the baby’s platelets. This antibody destroys the baby’s platelets, resulting in a low platelet count and an increased risk of bleeding for the baby.</p><p>The mother’s antibodies can remain in the baby’s blood stream for weeks, and bleeding can occur in the baby before birth (fetal), during birth or after birth (neonatal).</p><p>There are a number of proteins that can cause FNAIT but the most common one is human platelet antigen (HPA)-1a.</p><p>FNAIT does not occur because of anything the mother does, eats or drinks. It has not been linked to any environmental or dietary exposures.</p><h3>How common is FNAIT?</h3><p>FNAIT is rare. It occurs in about one in every 2,000 births.</p><h2>How is FNAIT diagnosed?</h2><p>Doctors may suspect a baby has FNAIT if there is:</p><ul><li>bleeding or bruising</li><li>a low platelet count on a blood test after birth</li><li>a specific pinpoint rash (called petechiae)</li></ul><p>The diagnosis of FNAIT can be confirmed by taking blood samples from the mother, the father and possibly the baby. If the baby’s platelet count is very low, doctors may look for possible bleeding in the brain using ultrasound.</p><h3>Why blood tests in pregnancy do not show that the baby may have FNAIT?</h3><p>Because FNAIT is rare, doctors do not usually screen for it. Doctors may first suspect a baby has FNAIT when they are born with bruises or a rash.</p><h2>How is FNAIT treated?</h2><p>Babies with FNAIT may need to be admitted to the neonatal intensive care unit for close monitoring.</p><p>The main treatment for FNAIT is platelet transfusions. These transfusions will help to prevent and treat the bleeding.</p><h2>What can be done to prevent FNAIT in future pregnancies?</h2><p>It is possible that FNAIT will occur in future pregnancies. This will depend on which platelet proteins the baby inherits from their mother and father.</p><p>If a woman becomes pregnant again, their doctor should refer them to a hospital that specializes in fetal-maternal medicine. If a woman is known to be at risk of FNAIT, their pregnancy should be followed by a multidisciplinary team of specialists including an obstetrician and a hematologist with expertise in FNAIT.</p><p>Doctors will closely monitor the pregnancy and may start treatment as early as 12 to 16 weeks of gestation. This treatment includes intravenous immunoglobulin (IVIG) and possibly steroids. Treatment is based on several factors that should be discussed with their doctor. Treatment will likely be needed to prevent a low platelet count in the fetus and newborn.</p><h3>Does FNAIT affect the mother during pregnancy?</h3><p>FNAIT does not directly affect the mother’s health, but once FNAIT is diagnosed in a baby, the mother’s future pregnancies should be followed by a specialist who may recommend preventative treatments for the mother.</p><h3>Should the mother's brother or sister be tested for FNAIT?</h3><p>A woman's sisters may have the same rare platelet protein combination and therefore should be tested. Other relatives do not need to be tested.</p><h2>What to expect</h2><h3>If a baby has FNAIT can they still be breastfed?</h3><p>If the baby's pediatrician says they are well enough to feed then breastfeeding them is safe.</p><h3>Will a baby with FNAIT always be at risk of having a low platelet count as they grow older?</h3><p>No, a baby's low platelet count should only last until a few weeks after their birth.</p><h3>Does having FNAIT mean a baby will have a weak immune system when they are older?</h3><p>No. There is no known association between FNAIT and a weak immune system.</p><h2>Where can I get more information?</h2><p>Visit <a href="https://www.naitbabies.org/">www.naitbabies.org</a>.</p><p>This document was created by the International Collaboration for Transfusion Medicine Guidelines (ICTMG), a group of international transfusion experts brought together to create and promote evidence-based guidelines to optimize transfusion care. For more information, visit the website at <a href="https://www.ictmg.org/">www.ictmg.org</a>.</p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT)

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