Isoimmune neutropenia of the newborn

• Maternal antibodies to fetal neutrophil antigens cross the placenta and give rise to neutropenia in the newborn child.

• Most commonly antibodies directed at neutrophil-specific antigens NA1 and NA2. (Maternal HLA antibodies do not cause trouble because antigens expressed on many tissues so quickly absorbed.)

• Estimated incidence up to 3% of newborns, so may be more common than generally appreciated; perhaps because usually clinically mild and neutropenia thought to be acquired due to drugs/infection.

• Condition resolves by 2 months as antibody disappears.

• Severely affected babies may show recurrent staphylococcal skin infections. Therapy supportive. Need for exchange transfusion very rare.

• Diagnosis based on serology.

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