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.
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.
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: firstname.lastname@example.org).
Received October 29, 2011
Accepted June 26, 2012