{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:52:27Z","timestamp":1791337947355,"version":"4.3.1"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Immune platelet transfusion refractoriness (PTR) is usually mediated by anti\u2010HLA class I antibodies; immunisation against CD36 (platelet glycoprotein IV [GPIV]) is relatively rare. Platelet CD36 deficiency shows marked ethnic variability and is seldom reported in admixed Latin American populations. We describe the diagnostic and transfusional challenges of anti\u2010CD36 alloimmunisation in a Brazilian patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A 48\u2010year\u2010old Brazilian woman with a myeloid\/lymphoid neoplasm with fibroblast growth factor receptor 1 (FGFR1) rearrangement developed severe PTR. Platelet antibodies were assessed by a Luminex\u2010based Pak\u2010Lx assay, CD36 expression by flow cytometry and CD36 genotyping by Sanger sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Platelet counts remained &lt;5\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L with absent corrected count increment and recurrent mucocutaneous bleeding. Platelet antibody testing showed isolated anti\u2010GPIV\/CD36 reactivity (median fluorescence intensity [MFI] 4388); no additional HLA class I or human platelet antigen (HPA) antibodies were detected. No CD36 expression was detected on the patient's platelets by flow cytometry, and CD36 gene sequencing identified two heterozygous variants (c.975T&gt;G and c.1079T&gt;G) known to be associated with CD36 deficiency. Crossmatches remained incompatible with all available platelet units, including from an HLA\u2010identical brother, reflecting the scarcity of CD36\u2010negative platelet donors. The patient died of disease progression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anti\u2010CD36 alloimmunisation should be considered in severe PTR with negative HLA antibody screening, particularly in heavily transfused patients from admixed populations. To our knowledge, this is the first Brazilian case of anti\u2010CD36 alloimmunisation causing severe PTR; platelet CD36 deficiency has previously been reported in a Brazilian woman with anti\u2010CD36 antibodies in the context of pregnancy, underscoring the importance of considering this antibody specificity in persistent PTR despite negative HLA and HPA antibody screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.70385","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:29:46Z","timestamp":1791336586000},"source":"Crossref","is-referenced-by-count":0,"title":["Immune platelet transfusion refractoriness associated with anti\u2010\n                    <scp>CD36<\/scp>\n                    alloimmunisation in a Brazilian patient with platelet\n                    <scp>CD36<\/scp>\n                    deficiency"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3022-092X","authenticated-orcid":false,"given":"Rayane Dayse Alves","family":"Conserva","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1646-5257","authenticated-orcid":false,"given":"Luiz Frederico Bezerra","family":"Honorato Junior","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1310-8275","authenticated-orcid":false,"given":"Ana Paula Hitomi","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4585-2066","authenticated-orcid":false,"given":"Thiago Henrique","family":"Costa","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Henrique Cardoso","family":"Fedeli","sequence":"additional","affiliation":[{"name":"Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cynira Franco","family":"Marret","sequence":"additional","affiliation":[{"name":"Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Perez","family":"Bastos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Pires de Souza","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana Nobrega","family":"Costa","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia Chiosini","family":"de Nadai","sequence":"additional","affiliation":[{"name":"Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5103-4970","authenticated-orcid":false,"given":"Carolina","family":"Bonet\u2010Bub","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-6731","authenticated-orcid":false,"given":"Jose Mauro","family":"Kutner","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.21037\/aob-21-36","article-title":"CD36 immunization causing platelet transfusion refractoriness: narrative review","volume":"6","author":"Sullivan MJ","year":"2021","journal-title":"Ann Blood"},{"key":"e_1_2_8_3_1","first-page":"213","article-title":"A new platelet\u2010specific antigen, Naka, involved in the refractoriness of HLA\u2010matched platelet transfusion","volume":"57","author":"Ikeda H","year":"1989","journal-title":"Vox 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their association with CD36 protein expression in platelets","volume":"12","author":"Xu X","year":"2014","journal-title":"Blood Transfus"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3343\/alm.2023.43.1.86","article-title":"Improvement of anti\u2010CD36 antibody detection via monoclonal antibody immobilization of platelet antigens assay by using selected monoclonal antibodies","volume":"43","author":"Xu X","year":"2023","journal-title":"Ann Lab Med"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1016\/j.htct.2024.06.004","article-title":"Platelet antibody detection assays: a single\u2010laboratory comparison of MAIPA, PIFT, and microsphere\u2010based multiplex assays Pak\u2010Lx","volume":"46","author":"Costa TH","year":"2024","journal-title":"Hematol Transfus Cell Ther"},{"key":"e_1_2_8_10_1","first-page":"123","article-title":"CD36 antibodies in isoimmunised African\u2010origin pregnant women: three years' experience in Spain","volume":"23","author":"Canals C","year":"2025","journal-title":"Blood Transfus"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"2638","DOI":"10.1111\/j.1537-2995.2010.02749.x","article-title":"Two cases of platelet transfusion refractoriness associated with anti\u2010CD36","volume":"50","author":"Saw C","year":"2010","journal-title":"Transfusion"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.21307\/immunohematology-2020-028","article-title":"A case of platelet transfusion refractoriness due to anti\u2010CD36 with a successful treatment outcome","volume":"35","author":"Khatri SS","year":"2019","journal-title":"Immunohematology"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/trf.18176","article-title":"Management challenge of a rare concomitant platelet glycoprotein IV\/CD36 and IIb\/IIIa deficiencies: case illustration","volume":"65","author":"Sekayan 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