Abstract:
BACKGROUND:Blood group A and B antigens are expressed only weakly on platelets (PLTs) of most individuals but are very strongly expressed on PLTs from approximately 1 percent of normal subjects (Type II high expressers). The implications of this trait for transfusion medicine are undefined. STUDY DESIGN AND METHODS:A family was studied in which two Group B infants were born with neonatal thrombocytopenia, whereas a third infant whose blood group was A(2) had a normal PLT count at birth. RESULTS:Serologic studies demonstrated a maternal antibody that reacted strongly with PLTs from the father and the two group B children in flow cytometry and with GPIIb/IIIa from their PLTs in solid-phase assays. No PLT-specific antibodies were detected in maternal serum sample, but it contained a high-titer immunoglobulin G antibody specific for blood group B. All PLT-reactive antibody in the mother's serum was removed by absorption with pooled, washed group A and B red cells (RBCs). Studies with monoclonal anti-B and measurement of serum B-glycosyltransferase activity showed that the father and both group B children were Type II high expressers of blood group B. CONCLUSIONS:The findings indicate that high-titer blood group antibodies acquired from the mother can cause thrombocytopenia in infants possessing the Type II high-expresser phenotype despite competition for antibody binding by blood group antigens expressed on RBCs and other tissues.
journal_name
Transfusionjournal_title
Transfusionauthors
Curtis BR,Fick A,Lochowicz AJ,McFarland JG,Ball RH,Peterson J,Aster RHdoi
10.1111/j.1537-2995.2007.01531.xsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
358-64issue
2eissn
0041-1132issn
1537-2995pii
TRF01531journal_volume
48pub_type
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