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DOI: 10.1055/s-0030-1270113
Intravenous Immunoglobulins for Neonatal Alloimmune Neutropenia Refractory to Recombinant Human Granulocyte Colony-Stimulating Factor
Publication History
Publication Date:
06 December 2010 (online)
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ABSTRACT
Neonatal alloimmune neutropenia (NAN) results from neutrophil destruction by transplacental maternal neutrophil-specific immunoglobulin G (IgG) antibodies directed against the antigen inherited from the father. Treatment is usually based on recombinant human granulocyte colony-stimulating factor (G-CSF) and prevention or treatment of infection. We report the case of neutropenia in a newborn discovered because of fetomaternal infection. The bone marrow biopsy showed normal cellularity. Granulocyte typing, granulocyte cross-matching, and serum assays showed anti-neutrophil antibodies specific for human neutrophil antigen-1c, an antigen rarely involved in this disease. This NAN was refractory to G-CSF but responded to intravenous immunoglobulin (IVIG). IVIG should be considered as a second-line treatment in NAN refractory to G-CSF. Clinical trials, however, are required to define the optimal management of NAN, a rare but probably underestimated life-threatening situation for newborns.
KEYWORDS
Intravenous immunoglobulin (IVIG) - neonatal alloimmune neutropenia (NAN) - recombinant human granulocyte colony-stimulating factor (G-CSF)
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Gilles CambonieM.D. Ph.D.
Neonatology, University Hospital Center of Montpellier, Arnaud de Villeneuve Hospital
371 Avenue du Doyen G. Giraud, 34295 Montpellier Cedex 5, France
Email: g-cambonie@chu-montpellier.fr