In patients with fetal and neonatal alloimmune thrombocytopenia (FNAIT), platelets are key in the development and treatment of this rare blood disorder.
What are platelets?
Platelets, which are also called thrombocytes, are described as small, colorless cellular fragments in a person’s blood that can form clots. In fact, platelets actually can prevent or stop bleeding by helping a person’s blood to clot.
Platelets are produced in the bone marrow, which is a soft, spongy type of tissue located inside the center of most of the bones in the human body. The bone marrow contains stem cells that develop into white blood cells, red blood cells, and platelets.
Learn more about FNAIT causes and risk factors
The role of platelets in patients with FNAIT
In patients with FNAIT, platelets play a key role. An abnormally low level of platelets in the blood, which is known as thrombocytopenia, is associated with an increased risk for bleeding.
Among individuals who have FNAIT, the platelets of their developing baby are attacked and destroyed by the immune cells found in the mother’s blood. In other words, the baby’s platelets are recognized by the mother as foreign, which leads to maternal antibodies being directed against human platelet antigens (HPAs). This means that the mother is developing an antibody response against these foreign agents
This leads to the development of alloantibodies against HPAs. Detecting and recognizing these HPA alloantibodies is crucial to rendering the correct diagnosis and guaranteeing that patients receive the best possible care.
What are some possible complications of low platelet levels?
In persons with FNAIT, there are a number of possible complications linked to abnormally low platelet counts, which can occur either prior to birth or up to four weeks after birth. These include:
- Skin discolorations, including petechiae and purpura, which are caused by bleeding under the skin may develop.
- Petechiae are described as pinpoint spots on the skin that frequently have a redder color than purpura. Purpura, on the other hand, are larger areas of skin discoloration that are more purple in color.
- Severe bruises, called hematomas, may be observed as well, which are actually collections of clotted blood.
- Infants with severe FNAIT may experience bleeding into a major organ or body system, including the brain, lungs, eyes and gastrointestinal tract.
- Intracranial hemorrhage, defined as bleeding in the brain, is severe and may lead to death.
Why does FNAIT actually develop?
It is not well understood why a mother’s immune system starts to attack her child’s platelets when they vary from her own platelets. In fact, just because the presence of platelet antigens involved in the FNAIT is confirmed does not necessarily mean that FNAIT will develop.
When FNAIT is observed, the mother’s immune system forms alloantibodies following exposure to the fetus’s or the newborn’s platelets.
