关键词: Glanzmann thrombasthenia immunization platelet antibody rFVIIa αIIbβ3

Mesh : Autoantibodies / blood immunology Humans Immunization Platelet Glycoprotein GPIIb-IIIa Complex / immunology metabolism Platelet Transfusion / adverse effects Risk Factors Thrombasthenia / blood immunology therapy Transfusion Reaction

来  源:   DOI:10.1111/bjh.15087

Abstract:
Glanzmann thrombasthenia (GT) is caused by inherited defects of the αIIb β3 platelet glycoprotein. This bleeding disorder can be treated with platelet transfusion therapy, but some patients will be immunized and begin to form anti-human leucocyte antigen (HLA) and/or anti-αIIb β3 antibodies. These antibodies can bind and interfere with the function of the transfused platelets, rendering treatment ineffective. However, platelet transfusion refractoriness attributable to HLA antibodies may be managed by the selection of compatible donors, although they are not always readily available, particularly in an emergency. Thus, anti-αIIb β3 antibodies represent one of the most severe complications in GT. Both genetic and environmental factors may contribute to the risk of anti-αIIb β3 development, but the underlying pathogenic mechanisms are still unknown. This review will summarize the current knowledge of the risk factors for development of anti-αIIb β3 antibodies in patients with GT and discuss how these findings may influence the clinical management of patients.
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