Trombocitopenia neonatal aloimune como causa de hemorragia intracraniana fetal: relato de caso
Conteúdo do artigo principal
Resumo
A produção de anticorpos maternos contra antígenos plaquetários fetais herdados do pai, e que gera destruição plaquetária significante, define a trombocitopenia neonatal aloimune. Caracteriza-se por intensa plaquetopenia, com expressivo sangramento mucocutâneo pós-natal, além de importante causa de sequelas neurológicas
em recém-nascidos decorrentes da hemorragia intracraniana que ocorre tanto intraútero quanto perinatal. Pelo fato de ser subdiagnosticada na prática clínica, buscou-se relatar o caso clínico com o intuito de discutir o diagnóstico, manejo clínico e importância da trombocitopenia neonatal aloimune, que se apresentou com
sangramento intracraniano fetal evidenciado durante avaliação ultrassonográfica do pré-natal.
Downloads
Detalhes do artigo

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Referências
1. Bertrand G, Blouin L, Boehlen F, Levine E, Minon JM, Winer N; working group on fetomaternal platelet alloimmunization of the French Group of Thrombosis, Hemostasis (GFHT). Management of neonatal thrombocytopenia in a context of maternal antiplatelet alloimmunization: Expert opinion of the French-speaking working group. Arch Pediatr. 2019 Apr;26(3):191-197.
2. Baker JM, Shehata N, Buseel J, et al. Postnatal intervention for the treatment of FNAIT: a systematic review. J Perinatol 2019; 39:1329.
3. Kamphuis M, Paridaans N, Porcelijn L, Lopriore E, Oepkes D. Incidence and consequences of neonatal alloimmune throbomcytopenia: A systematic review. Pediatrics 2014;133:715-21.
4. Fu J, Yao R, Yong W. A case report of prenatal diagnosis of fetal alloimmune thrombocytopenia: A CARE-compliant article. Medicine (Baltimore). 2021 Jun 18;100(24):e26092.
5. Brojer E, Husebekk A, Debska M, Uhrynowska M, Guz K, Orzinska A, et al. Fetal / neonatal alloimmune thrombocytopenia: Pathogenesis, diagnosis and prevention. Arch Immunol Ther Exp 2016;64:279-90.
6. Kovanlikaya A, Tiwari P, Bussel JB. Imaging and management of fetuses and neonates with alloimmune thrombocytopenia. Pediatr Blood Cancer 2017; 64.
7. Delbos F, Bertrand G, Croisille L, el al. Fetal and neonatal alloimmune thrombocytopenia: predictive factors of intracranial hemorrahage. Transfusion 2016; 56:59.
8. Lieberman L, Greinacher A, Murphy MF, Bussel J, et al. International Collaboration for Transfusion Medicine Guidelines (ICTMG). Fetal and neonatal alloimmune thrombocytopenia: recommendations for evidence-based practice, na international approach. Br J Haematol. 2019 May;1853):549-562.
9. Regan F, Lees CC, Jones B, Nicolaides KH, el al. Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocutopenia (FNAIT): Scientific Impact Paper No. 61. BJOG. 2019 Sep;126(10):e173-e185.
10. Bakchoul T, Bassler D, Heckmann M, et al. Management of infants born with severe neonatal alloimmune thrombocytopenia: the role of platelet transfusions and intravenous immunoglobulin. Transfusion 2014; 54:640.
11. Villar J, Cheikh I, Victora C, Ohuma E, Bertino E, Altman DG, et al. International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384:857-68.
12. Winkelhorst D, Oepkes D, Lopriore E. Fetal and neonatal alloimmune thrombocytopenia: evidence based antenatal and postnatal management strategies. Expert Ver Hematol 2017; 10:729.