Neonatal alloimmune thrombocytopenia (NAIT) is a rare but serious condition that affects newborns, with an incidence of one in 1,000 to 1,500 live births.1 NAIT occurs when the mother's immune system forms antibodies against fetal platelets. These antibodies cross the placenta and destroy the baby's platelets, leading to thrombocytopenia (a low platelet count).
Signs and Symptoms
Signs and symptoms of NAIT in newborns can range from no symptoms to severe bleeding. Common signs include petechiae (small red or purple spots on the skin), purpura (larger areas of bleeding under the skin), and bruising. The most feared complication is intracerebral hemorrhage (ICH), which can occur in utero or after birth and can lead to long-term neurological damage or death.1,2,3
Diagnosis
A diagnosis of NAIT should be considered in any newborn with unexplained thrombocytopenia. Confirming the diagnosis involves detecting maternal antibodies against specific platelet antigens and matching these against the antigens present on the baby's platelets.1
Prevention and Treatment
Once diagnosed, subsequent pregnancies are at risk for severe disease. Management strategies include close monitoring, the use of antenatal therapies such as intravenous immunoglobulin (IVIG) and steroids for high-risk mothers, and planning delivery where appropriate support is available.1 Treatment options for affected newborns include HPA-matched platelet transfusions and IVIG to raise the platelet count and reduce the risk of bleeding.1,4
Preventive measures are crucial, especially since the condition can recur in future pregnancies with increased severity.
The Role of Genetics
Recent studies have highlighted the impact of certain genetic factors, such as the HLA-DRB3*01:01 allele, on the risk of alloimmunization and severe neonatal thrombocytopenia. Mothers with this allele have a higher risk of having children with severe NAIT.2
Long-term Outlook
The long-term prognosis for infants with NAIT varies. While many recover with appropriate treatment, some may experience developmental delays or other long-term effects from ICH. Follow-up studies are essential for monitoring the neurodevelopmental outcomes of these children.1
How BioMatrix Can Help
Though a NAIT diagnosis can feel overwhelming, it’s important to know that you are not alone. BioMatrix helps manage the individual needs of patients requiring IVIG therapy. Knowledgeable pharmacists and care coordination staff guide each patient through the potential medication side effects and, working with the prescribing physician, help manage treatment to reduce the prevalence and severity of symptoms.
The BioMatrix clinical team includes compassionate nurses who have extensive training and experience with rare diseases, infusion therapies, and complex medical conditions. Our nurses work together with patients, caregivers, pharmacists, and prescribers to coordinate the optimal site of care, conduct nursing interventions, and provide patient education.
Learn more about our individualized specialty pharmacy services for patients with NAIT and other rare, and ultra-rare diseases.
Insurance Appeal Letter Sample & Template
Have you been denied insurance coverage for much needed treatment? Use this appeal letter template as a guide to help you or a loved one appeal insurance claim denials.
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References
Mella, M. T., & Eddleman, K. (2015). Neonatal alloimmune thrombocytopenia. International Journal of Clinical Transfusion Medicine, 29. https://doi.org/10.2147/ijctm.s51926
Kjeldsen‐Kragh, J., Fergusson, D., Kjær, M., Lieberman, L., Greinacher, A., Murphy, M., Bussel, J. B., Bakchoul, T., Corke, S., Bertrand, G., Oepkes, D., Baker, J. M., Hume, H., Massey, E., Kaplan, C., Callum, J., Baidya, S., Ryan, G., Savoia, H., . . . Shehata, N. (2020). Fetal/neonatal alloimmune thrombocytopenia: a systematic review of impact of HLA-DRB3*01:01 on fetal/neonatal outcome. Blood Advances, 4(14), 3368–3377. https://doi.org/10.1182/bloodadvances.2020002137
Lablogatory, A. (2021, January 26). Case Study: Newborn with Thrombocytopenia and Bruising. Lablogatory. https://labmedicineblog.com/2021/01/26/case-study-newborn-with-thrombocytopenia-and-bruising/
Conti, F. M., Hibner, S., Costa, T. H., Dezan, M. R., Aravechia, M. G., Pereira, R. A., Kondo, A. T., D'Amico, É. A., Mota, M., & Kutner, J. M. (2014). Successful management of neonatal alloimmune thrombocytopenia in the second pregnancy: a case report. Einstein (Sao Paulo, Brazil), 12(1), 96–99. https://doi.org/10.1590/s1679-45082014rc2729
