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Alloimmune Neonatal Neutropenia in Croatia during the 1998–2008 Period

Authors

  • Maja Tomicic,

    Corresponding author
    1. Department of Platelet and Leukocyte Diagnosis and Hemostasis, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
    • Correspondence

      Maja Tomicic, Department of Platelet and Leukocyte Diagnosis and Hemostasis, Croatian Institute of Transfusion Medicine, Petrova 3, HR-10000 Zagreb, Croatia.

      E-mail: maja.tomicic@hztm.hr

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  • Mirta Starcevic,

    1. Division of Neonatology, Department of Gynecology and Obstetrics, Zagreb University Hospital Center, Zagreb, Croatia
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  • Rebeka Ribicic,

    1. Division of Neonatology, Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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  • Branka Golubic-Cepulic,

    1. Clinical Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Center, Zagreb, Croatia
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  • Zeljka Hundric-Haspl,

    1. Education Department, Reference Affairs, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
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  • Irena Jukic

    1. Education Department, Reference Affairs, Croatian Institute of Transfusion Medicine, Zagreb, Croatia
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  • Key notes: Alloimmune neonatal neutropenia (ANN) is the result of maternal alloimmunization during pregnancy to fetal neutrophil antigens inherited from the father. It is a rare but potentially life-threatening disorder, especially in case of severe bacterial infection and sepsis, therefore demanding early diagnosis. The introduction of systematic laboratory monitoring of neutrophil count in neonatal blood and serologic testing for ANN in case of isolated neutropenia in the newborn contributed considerably to timely detection of ANN.

Abstract

Problem

The aim of this study was to estimate the incidence of the disease and to analyze laboratory data of 23 newborns undergoing serologic testing for alloimmune neonatal neutropenia (ANN) during the 1998–2008 period in Croatia.

Method of study

Laboratory data on 23 newborns undergoing serologic testing for ANN during the 1998–2008 period and epidemiologic data on the number of live births in Croatia were analyzed. Laboratory testing for ANN included serologic screening of maternal and neonatal sera and granulocytes (neutrophils) by immunofluorescence (IF) method. The monoclonal antibody immobilization of neutrophil antigens (MAINA) was employed to determine anti-HNA antibody specificity.

Results

Anti-HNA antibodies were detected in seven (54%) of 13 cases of serologically positive ANN. Only anti-HLA class I antibodies were demonstrated in four (31%) of 13 cases In the 2007–2008 period of prospective data collection, the number of serologically verified ANN cases was one case per 17,323 live births.

Results of the prospective study conducted at Maternity Ward, Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center yielded the ANN incidence of one case per 2843 live births.

Conclusion

Monitoring of neutrophil count in neonatal blood and serologic testing for ANN in case of isolated neutropenia in the newborn contributed considerably to timely detection of ANN.

Descriptors

Neonatal alloimmune neutropenia—incidence, serologic diagnosis, antineutrophil antibodies, anti-HNA, anti-HLA class I, Croatia.

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