{
  "abstract": "Background and Objectives. Many studies documented the transmission of anti-platelet antibodies in maternal autoimmune thrombocytopathies. It is unclear whether this also occurs in alloimmune thrombocytopenia. Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is a rare immunological disorder resulting from maternal sensitization against paternal human platelet antigens (HPA) inherited by the fetus. While postnatal management typically focuses on HPA-matched platelet transfusions, the impact of breastfeeding remains a subject of clinical debate. This study aims to investigate whether the excretion of anti-platelet alloantibodies into breast milk may contribute to prolonged or refractory neonatal thrombocytopenia. Methods. We report a clinical case of a female neonate (39 weeks’ gestation, spontaneous delivery) presenting with severe FNAIT-related thrombocytopenia (21x109/L) and grade III-IV intraventricular hemorrhage. IgG-class alloantibodies were quantified in both maternal and neonatal sera using flow cytometry (DxFLEX platform), yielding values of 2613 and 580 Mean Fluorescence Intensity (MFI), respectively (cutoff: 300 MFI). Results. Standard therapeutic interventions, including IgG, corticosteroids, and multiple HPA-matched platelet transfusions, failed to maintain stable counts; platelet levels dropped by over 50% within five days post-transfusion (declining from 154-176 to 26-63x109/L. Given the ongoing breastfeeding and persistent maternal serum positivity (1800 MFI), breast milk was analyzed following IgG extraction. Testing confirmed the presence of anti-platelet alloantibodies in the milk (552 MFI vs. 173 MFI in the negative control). Following these findings, breastfeeding was restricted to a single daily feed. Within one week, the neonate’s platelet count rose from 48 to 80x109/L without requiring further transfusions. Conclusions. This case demonstrates the presence of HPA-specific alloantibodies in breast milk, coinciding with a case of refractory early-onset thrombocytopenia. These findings suggest that the management of breastfeeding in FNAIT should be carefully examinated. Further research is required to determine the clinical significance of milk-derived antibodies versus the persistence of transplacentally acquired maternal IgG.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "name": "Daniela Dragonetti"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0hknhymd8ay8h.bib",
  "cited_by": 0,
  "doi": null,
  "fulltext_url": "https://www.btvb.org/btvb/article/view/852",
  "id": "0hknhymd8ay8h",
  "issns": [
    "2785-5309"
  ],
  "landing_url": "https://www.btvb.org/btvb/article/view/852",
  "language": "en",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "PAGEPress Publications",
  "ris": "https://research.draconitic.com/paper/0hknhymd8ay8h.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:47:30Z",
      "native_id": "61a327c21a27425a8b88397c24a45204",
      "source": "doaj",
      "url": "https://www.btvb.org/btvb/article/view/852"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    }
  ],
  "title": "PO036 | EVALUATION OF BREAST MILK AS A POTENTIAL MEDIATOR FOR THE TRANSFER OF MATERNAL ANTI-PLATELET ALLOANTIBODIES IN FETAL AND NEONATAL ALLOIMMUNE THROMBOCYTOPENIA",
  "title_text": "PO036 | EVALUATION OF BREAST MILK AS A POTENTIAL MEDIATOR FOR THE TRANSFER OF MATERNAL ANTI-PLATELET ALLOANTIBODIES IN FETAL AND NEONATAL ALLOIMMUNE THROMBOCYTOPENIA",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:30Z",
  "url": "https://research.draconitic.com/paper/0hknhymd8ay8h",
  "venue": "Bleeding, Thrombosis and Vascular Biology",
  "versions": []
}