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DOI: 10.1055/s-0030-1270113
Intravenous Immunoglobulins for Neonatal Alloimmune Neutropenia Refractory to Recombinant Human Granulocyte Colony-Stimulating Factor
Publikationsverlauf
Publikationsdatum:
06. Dezember 2010 (online)
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)
REFERENCES
- 1 Berliner N, Horwitz M, Loughran Jr T P. Congenital and acquired neutropenia. Hematology (Am Soc Hematol Educ Program). 2004; 63-79
- 2 Bux J, Jung K D, Kauth T, Mueller-Eckhardt C. Serological and clinical aspects of granulocyte antibodies leading to alloimmune neonatal neutropenia. Transfus Med. 1992; 2 143-149
- 3 Williams B A, Fung Y L. Alloimmune neonatal neutropenia: can we afford the consequences of a missed diagnosis?. J Paediatr Child Health. 2006; 42 59-61
- 4 Tomicic M, Starcevic M, Zach V, Hundric-Haspl Z. Alloimmune neonatal neutropenia due to anti-HNA-2a alloimmunization with severe and prolonged neutropenia but mild clinical course: two case reports. Arch Med Res. 2007; 38 792-796
- 5 Verheugt F W, von dem Borne A E, Décary F, Engelfriet C P. The detection of granulocyte alloantibodies with an indirect immunofluorescence test. Br J Haematol. 1978; 38 151
- 6 Jiang A F, Lalezari P. A micro-technique for detection of leukocyte agglutinins. J Immunol Methods. 1975; 7 103-108
- 7 Bux J, Kober B, Kiefel V, Mueller-Eckhardt C. Analysis of granulocyte-reactive antibodies using an immunoassay based upon monoclonal-antibody-specific immobilization of granulocyte antigens. Transfus Med. 1993; 3 157-162
- 8 Fasth A. Immunoglobulin for neonatal agranulocytosis. Arch Dis Child. 1986; 61 86-87
- 9 Minchinton R M, McGrath K M. Alloimmune neonatal neutropenia—a neglected diagnosis?. Med J Aust. 1987; 147 139-141
- 10 Gilmore M M, Stroncek D F, Korones D N. Treatment of alloimmune neonatal neutropenia with granulocyte colony-stimulating factor. J Pediatr. 1994; 125 (6 Pt 1) 948-951
- 11 Rodwell R L, Gray P H, Taylor K M, Minchinton R. Granulocyte colony stimulating factor treatment for alloimmune neonatal neutropenia. Arch Dis Child Fetal Neonatal Ed. 1996; 75 F57-F58
- 12 Bédu A, Rohrlich P, Farnoux C et al.. [Neonatal alloimmune neutropenias. Importance of treatment with granulocyte colony-stimulating factor (G-CSF). Report of 2 new cases]. Arch Pediatr. 1999; 6 1297-1301
- 13 Kerst J M, de Haas M, van der Schoot C E et al.. Recombinant granulocyte colony-stimulating factor administration to healthy volunteers: induction of immunophenotypically and functionally altered neutrophils via an effect on myeloid progenitor cells. Blood. 1993; 82 3265-3272
- 14 Stroncek D F, Shankar R, Litz C, Clement L. The expression of the NB1 antigen on myeloid precursors and neutrophils from children and umbilical cords. Transfus Med. 1998; 8 119-123
- 15 Bedu A, Baumann C, Rohrlich P, Duval M, Fenneteau O, Cartron J. Failure of granulocyte colony-stimulating factor in alloimmune neonatal neutropenia. J Pediatr. 1995; 127 508-509
- 16 Maheshwari A, Christensen R D, Calhoun D A. Resistance to recombinant human granulocyte colony-stimulating factor in neonatal alloimmune neutropenia associated with anti-human neutrophil antigen-2a (NB1) antibodies. Pediatrics. 2002; 109 e64
- 17 Bux J. International Society of Blood Transfusion . Nomenclature of granulocyte alloantigens. ISBT Working Party on Platelet and Granulocyte Serology, Granulocyte Antigen Working Party. Transfusion. 1999; 39 662-663
- 18 Bux J, Stein E L, Bierling P et al.. Characterization of a new alloantigen (SH) on the human neutrophil Fc gamma receptor IIIb. Blood. 1997; 89 1027-1034
- 19 Hessner M J, Shivaram S M, Dinauer D M, Curtis B R, Endean D J, Aster R H. Neutrophil antigen (FcgammaRIIIB) SH gene frequencies in six racial groups. Blood. 1999; 93 1115-1116
- 20 Curtis B R, Reno C, Aster R H. Neonatal alloimmune neutropenia attributed to maternal immunoglobulin G antibodies against the neutrophil alloantigen HNA-1c (SH): a report of five cases. Transfusion. 2005; 45 1308-1313
- 21 Latini G, Del Vecchio A, Rosati E, Borzini P, Chirico G, Rondini G. Different responses to granulocyte colony-stimulating factor treatment in siblings with alloimmune neonatal neutropenia. Acta Paediatr. 1999; 88 1407-1409
- 22 Cairo M S. Cytokines: a new immunotherapy. Clin Perinatol. 1991; 18 343-359
- 23 Larroche C, Chanseaud Y, Garcia de la Pena-Lefebvre P, Mouthon L. Mechanisms of intravenous immunoglobulin action in the treatment of autoimmune disorders. BioDrugs. 2002; 16 47-55
- 24 Boros P, Gondolesi G, Bromberg J S. High dose intravenous immunoglobulin treatment: mechanisms of action. Liver Transpl. 2005; 11 1469-1480
- 25 Galeotti C, Maddur M S, Kazatchkine M D, Mouthon L, Kaveri S V. [Intravenous immunoglobulins in autoimmune and inflammatory disorders: beyond a simple substitution]. Transfus Clin Biol. 2009; 16 75-79
- 26 Cartron J, Tchernia G, Celton J L et al.. Alloimmune neonatal neutropenia. Am J Pediatr Hematol Oncol. 1991; 13 21-25
- 27 Navarro M, Negre S, Matoses M L, Golombek S G, Vento M. Necrotizing enterocolitis following the use of intravenous immunoglobulin for haemolytic disease of the newborn. Acta Paediatr. 2009; 98 1214-1217
- 28 Figueras-Aloy J, Rodríguez-Miguélez J M, Iriondo-Sanz M, Salvia-Roiges M D, Botet-Mussons F, Carbonell-Estrany X. Intravenous immunoglobulin and necrotizing enterocolitis in newborns with hemolytic disease. Pediatrics. 2010; 125 139-144
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