Persistent neonatal thrombocytopenia can be caused by IgA antiplatelet antibodies in breast milk of immune thrombocytopenic mothers

Blood. 2015 Jul 30;126(5):661-4. doi: 10.1182/blood-2014-12-614446. Epub 2015 Jun 15.


Immune thrombocytopenia (ITP) in pregnant women can cause neonatal thrombocytopenia by transport of antiplatelet autoantibodies across the placenta. Usually, an infant's platelet count normalizes within 2 months. We observed neonatal thrombocytopenia that persisted more than 4 months and disappeared following discontinuation of breastfeeding. The aim of our study was to discern whether breast milk of ITP mothers contained antiplatelet antibodies causing persistent thrombocytopenia. We collected milk samples from 3 groups of women: ITP group, 7 women who had ITP during pregnancy; R-ITP group, 6 women who recovered from ITP before pregnancy; and 9 healthy controls. We found increased levels of antiplatelet antibodies of the immunoglobulin A type in the milk of ITP patients compared with the other 2 groups. Similar increase was demonstrated for antibodies binding to αIIbβ3 expressed in cultured cells. Thus, transfer of antiplatelet antibodies from ITP mothers by breastfeeding can be associated with persistent neonatal thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies / metabolism*
  • Blood Platelets / immunology*
  • Breast Feeding / adverse effects
  • Case-Control Studies
  • Cells, Cultured
  • Female
  • Humans
  • Immunoglobulin A / metabolism
  • Infant
  • Infant, Newborn
  • Maternal-Fetal Exchange / immunology
  • Milk, Human / immunology*
  • Platelet Count
  • Platelet Glycoprotein GPIIb-IIIa Complex / immunology
  • Pregnancy
  • Pregnancy Complications, Hematologic / immunology*
  • Purpura, Thrombocytopenic, Idiopathic / complications*
  • Purpura, Thrombocytopenic, Idiopathic / immunology
  • Thrombocytopenia, Neonatal Alloimmune / etiology*
  • Thrombocytopenia, Neonatal Alloimmune / immunology


  • Autoantibodies
  • Immunoglobulin A
  • Platelet Glycoprotein GPIIb-IIIa Complex