Alloimmun Sitopeniler

İmmunsitopeniler eritrosit, trombosit ve nötrofillerin veya aynı anda bir- den fazla hücre serisinin “otoantikorlar” veya “alloantikorlar” tarafından uyarılmış immun sistem aracılığı ile yıkımı sonucu meydana gelir. Alloantikorlar, organizmanın karşılaştığı alloantijen veya izoantijen deni- len aynı türden ve kendine ait olmayan antijenlerle uyarılması ile oluşur. Kan grubu ve doku grubu antijenleri bunlara örnek olarak gösterilebilir. Oluşan bu antikorlar genellikle geçici bir dönem kan hücrelerinin yıkımına neden olurlar. Otoimunite ise immun toleransın bozularak organizmanın tüm savunma sisteminin kendi antijenlerini yabancı görmesi ve hücrelerin yıkımına/ hasarına yol açmasıdır. Otoimmun hastalıklar tüm organ sistemlerini etkileyebilir. Alloimmunizasyon kan transfüzyonu reaksiyonları, yenidoğan sitopenileri veya organ transplantasyonu sonrası görülen greft rejekti ile karşımıza çıkabilir. Bu yazıda kan transfüzyonu reaksiyonları ve yenidoğanın alloim- munsitopenilerinden bahsedilecektir.

Anahtar Kelimeler:

Alloimmunizasyon, sitopeni, yenidoğan, çocuk

Alloimmune Cytopenias

Immune cytopenias occur as a result of the destruction of erythrocytes, platelets, and neutrophils or more than one cell line at the same time through the immune system stimulated by autoantibodies or alloantibodies. Alloantibodies are formed when the organism is stimulated when it encounters antigens of the same type, called alloantigen or isoantigen, and which do not belong to it. Examples include blood group antigens and tissue group antigens. These antibodies usually cause the destruction of blood cells for a temporary period. Autoimmunity, on the other hand, is when the immune tolerance is disrupted and the entire defence system of the organism sees its own antigens as foreign and causes the destruction/damage of the cells. Autoimmune diseases can affect all organ systems. Alloimmunization may present with blood transfusion reactions, neonatal cytopenias or graft rejection after organ transplantation. In this article, blood transfusion reactions and alloimmune cytopenias of newborns will be discussed.

Keywords:

Alloimmunisation, cytopenia, neonate, child,

PDF

___

1. Sahdev I, Abdel-Azim H. Hematopoietic Stem Cell Transplantation. In Lanzkowsky P, Lipton MJ, Manual of PediatricHematology and Oncology 6th ed. Academic Press: London 2016;31:577-620. google scholar
2. Vengelen-Tyler V (ed). Noninfectious Complications of Blood Transfusion. In: Technical Manual. 12th ed. Bethesda, MD: American Association of Blood Banks 1996:558-9. google scholar
3. Lane TA. Transfusion Reactions In: Blood Transfusion Therapy: A Physician Handbook. 5th ed. Bethesda, MD: American Association of Blood Banks, 1996:103115. google scholar
4. Schroeder ML: Principles and Practice of Transfusion Medicine. In: Wintrobe’s Clinical Hematology 10th ed. Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM editors. Egypt, Mass Publishing Co. 1999:817-74. google scholar
5. Ar MC. Trombosit Transfüzyonu. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Herkes İçin Transfüzyon Tıbbı Sempozyum Dizisi. 2005;44:151-161. google scholar
6. Chavez MF, Mulinare J, Edmonds LD. Epimemiyology of Rh Haemolytic disease of newborn in the United States. J Am Med Assoc 1991;265:3270-4. google scholar
7. Dean L. Blood group and red celantigens. National center for biotechnology information (NCBI). National Library of Medicine, National Intitutes of Health Bethesda, 2005. google scholar
8. McDonnel M, Hannam S, DevaneSP. Hydrops fetalis due to ABO incompatibility: ArcDis Child Fetal Neonatal Ed 1998;78:220-5. google scholar
9. Thompson S. Eggington J, Dodd A, Qureshi R, Turner E. Late developing red cell antibodies in pregnancy. Transfusion Medicine 2003;18:8-9. google scholar
10. Bertil Glader. Immune haemolytic anemias. In Arceci R.J, Hann IM and Smith OP editors. Pediatric Hematology. 3rd ed. Oxford. Blackwell Publishing 2006.p.151-70. google scholar
11. Espinoza JP, Caradeux J, Norwitz ER. Fetal and neonatal alloimmun thrombocytopenia. Rew Obstet Gynecol 2013;6:15-21. google scholar
12. Ünal S. Fetal ve Neonatal Alloimmun Trombositopeni. In Ören H, Koç A, Bör Ö, editors. TPHD Eğitim Serisi-III, Yenidoğan Hematolojisi. Galenos Yayıncılık, İstanbul. 2016;1(3):551-6. google scholar
13. Kaplan C. Neonatal alloimmune thrombocytopenia. Haematologica 2008;93:805-7. google scholar
14. Roberts I, Stanworth S, Murray NA. Thrombocytopenia in the neonate. Blood Rev 2008;22:173-86. google scholar
15. Farruga P. Immune neutropenias of infancy and childhood. World J Pediatr 2016;12:142-8. google scholar
16. Walkovich KJ, Newburge PE. Leucophenia. In: Keligmann RM, Stanton BF, Geme JW, editors. Nelson Textbook of Pediatrics. 20th ed. Pheledephia, Elsevier, 2016;1047-53. google scholar
17. Koç, A. İmmun Nötropeniler. Ören H, Karakaş Z, Koç A, Özbek NY, editorler. TPHD Eğitim Serisi-V, Lökosit Hastalıkları. Galenos Yayıncılık, İstanbul. 2017;2(5):232-43. google scholar
18. Dinauer MC, Newburger PE, Borregaard N. Phagocytesystem 1 and disorders of granulopoiesis and granulocyte function In. Nathan and Oski’s hematology and oncology of infancy and childhood. 8th ed. Philedelphia, Elsevier Saunders, 2015;773-847. google scholar