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Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 172-175

A case of neonatal alloimmune neutropenia with an uncommon presentation

1 Department of Pediatrics, Hospital de Braga, Braga, Portugal
2 Neonatal Intensive Care Unit, Hospital de Braga, Braga, Portugal
3 Department of Hematology, Hematological Diagnosis Unit, Cytometry and Genetics Laboratories, Centro Hospitalar Universitário do Porto, Porto, Portugal

Correspondence Address:
Marta Ribeiro Silva
Serviço de Pediatria, Hospital de Braga, Braga, Portugal.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.jcn_28_21

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Neonatal alloimmune neutropenia (NAN) is a rare condition in neonates, with an incidence of <0.1%. It occurs when maternal antibodies against neutrophil antigens inherited from the father cross the placenta, destroying the neutrophils of the fetus and/or the newborn. We report a case of a female neonate who started exhibiting scattered petechiae over the trunk and lower limbs, a day after birth. The blood count revealed severe neutropenia and mild thrombocytopenia. Infections were excluded. Flow cytometry analysis confirmed the presence of antineutrophil immunoglobulin G antibodies in the newborn's neutrophil membrane and in the mother's serum. When screened for polymorphisms in the genes encoding for human neutrophil antigens (HNA), we identified HNA-1b and/or HNA-3a as potential causes of the mother/daughter incompatibility. Even though neutropenia is usually self-limiting, neonates with NAN are at risk of developing severe infections. Therefore, early identification of these patients can prevent serious complications.

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