S21 

Case Of NAIT Causing Severe Thrombocytopenia due to Anti-HLA Class I 
 

Noor Aqilah Binti Ashamuddin1, Dr Sabariah Binti Mohd Noor1, Dr Irni Binti Mohd Yasin1 

 

 

Abstract 

 

Neonatal alloimmune thrombocytopenia (NAIT) is the leading cause of thrombocytopenia in 

otherwise healthy new-born. (1,2) Maternal antibodies raised against paternally inherited 

alloantigen carried on fetal platelet causing NAIT. Maternal IgG antibodies passed through to 

the fetal via the placenta, attack and cause the destruction of the fetal platelet. (3) We present 

a case of NAIT without any complications in a premature baby (35 weeks) with VACREL 

association, G6PD deficiency, left calcified cephalohaematoma, cardiomegaly and 

hypospadias with severe thrombocytopenia (platelet counts is 23 109/L) at day two of life and 

received twice platelet transfusion. Platelet count initially 123 109/L at birth but significantly 

drop and persistently less than 50 109/L until day 10 of life before it normalized. Maternal 

serum antibody screening was negative, but platelet immunology test detected maternal 

platelet-reactive antibody Anti-HLA Class I and correlates with incompatible parental 

crossmatch indicating that parent had “platelet-antigen incompatibility”. The goal of obstetric 

management is to identify pregnancies at risk and prevent intracranial haemorrhage. (4) There 

is no evidence to support routine screening for pregnancies as per current practice. (2, 5) The 

latest treatments include maternal administration of intravenous immunoglobulin to suppress 

maternal antibody production and or to reduce placental transfer of antibodies; with or without 

steroids during antepartum period besides planning of mode, timing and method of delivery. 

(2, 5, 6, 7) This is a rare and unique case of NAIT secondary to Anti-HLA Class I antibody and 

hence clinician should be au fait with the diagnosis and management as it is infrequent among 

Malaysian. 

Keywords: Neonatal Alloimmune Thrombocytopenia (NAIT), Anti-HLA Class I, Platelet 

Antibody 

 

1. Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia 

  

DOI: http://dx.doi.org/10.31344/ijhhs.v5i0-2.339  
 

http://dx.doi.org/10.31344/ijhhs.v5i0-2.339