We read with great interest the recent original article in the April edition of the journal which studied the maternal and fetal outcomes of pregnancy in patients with immune thrombocytopenic purpura (ITP) [1], and we appreciate the authors for the effort. As neonatologists managing babies born to mothers with ITP in our hospital, a quick scan of the abstract, which is intended to mirror the study, piqued our interest. To our surprise, three babies with neonatal alloimmune thrombocytopenia (NAIT) secondary to maternal ITP were reported, a finding previously never described in the literature. The authors, however, did not seem to find this unique and did not appear to highlight this new and interesting finding. The full article compounded the problem by repeatedly misclassifying neonatal autoimmune thrombocytopenia as NAIT (neonatal alloimmune thrombocytopenia).
Transplacental passage of maternal platelet autoantibodies in mothers with ITP can cause neonatal autoimmune thrombocytopenia, whereas neonatal alloimmune thrombocytopenia (NAIT) is caused by transplacental passage of maternal alloantibodies directed against fetal platelet antigens inherited from the father but absent on maternal platelets. Intracranial hemorrhage can occur in 10% of NAIT cases, whereas its incidence is 1% or less in neonatal autoimmune thrombocytopenia [2]. Equating these two entities is not right, as both are entirely different diseases with different pathologies and with different outcomes in newborn. The article in itself repeats both the acronym (NAIT) as well as its expansion as alloimmune thrombocytopenia repeatedly in its full text, thus making it factually and scientifically incorrect.
The natural tendency of a busy clinician or a student is to go through the abstracts of medical journals and accept the result or conclusion given in the abstract as right evidence without critically appraising the entire study. An abstract, defined as a self-contained, short, powerful statement describing a larger body of work, should ideally reflect the study, acting as the trailer for the movie(article) which is to follow [3].
We are not sure why the error occurred—whether it was a mistake by the authors (the director) or whether it happened during the printing (post-production work). We would like to make a suggestion to the editors, perhaps the best method for avoiding an error such as this (if clerical) might be to include an abbreviations list in the manuscript.
Declarations
Conflict of interest Nil.
