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Neonatal Alloimmune Neutropenia: Still a Diagnostic and Therapeutical Challenge

Águeda, Sofia MD; Rocha, Gustavo MD; Ferreira, Fátima MD; Vítor, Bonito MD; Lima, Margarida MD; Guimarães, Hercília PhD

Journal of Pediatric Hematology/Oncology: October 2012 - Volume 34 - Issue 7 - p 497–499
doi: 10.1097/MPH.0b013e318266c3b5
Original Articles

Objective: To describe a case of neonatal alloimmune neutropenia (NAN), a very rare disease of the newborn and the first ever reported in our neonatal intensive care unit, with emphasis in its management and outcome.

Description: We report a case of NAN due to anti-human neutrophil antigen-1b alloimmunization in a 29-week preterm admitted to our neonatal intensive care unit. In this case, the neutropenia was severe and persisted for almost 2 months. There was a good response to the administration of intravenous immunoglobulin.

Comments: NAN is caused by maternal production of neutrophil-specific alloantibodies in response to antigens from paternal heritage present on the newborn neutrophiles. The course of the disease is usually mild and self-limiting. The optimal therapy is yet a debate, with some authors finding the use of intravenous immunoglobulin effective, prophylactic antibiotic therapy or recombinant human granulocyte colony-stimulating factor.

*Neonatal Intensive Care Unit

Departments of Hematology

Pediatric, Hospital São João, EPE, Alameda Prof. Hernâni Monteiro

§Department of Imunohemotherapy, Hospital Geral Santo António—Centro Hospitalar do Porto

Faculty of Medicine, University of Porto, Porto, Portugal

The authors declare no conflict of interest.

Reprints: Gustavo Rocha, MD, Neonatal Intensive Care Unit, Hospital São João, EPE, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal (e-mail: gusrocha@oninet.pt).

Received October 29, 2011

Accepted June 26, 2012

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.