Gall Brent, Yee Adrian, Berry Brian, Bircham Deborah, Hayashi Allen, Dansereau Jerome, Hart Jason
Faculty of Medicine, University of British Columbia Vancouver BC.
J Obstet Gynaecol Can. 2010 Dec;32(12):1167-1171. doi: 10.1016/S1701-2163(16)34741-7.
Rituximab is a novel therapy for immune thrombocytopenic purpura (ITP); however, information about its safety in pregnancy is limited. This case illustrates the successful use of rituximab to treat pregnancy-associated ITP.
A 34-year-old woman presented with severe ITP at 23 weeks' gestation. Standard treatment with corticosteroids, intravenous immune globulin, and splenectomy failed to raise the platelet count. Due to ongoing bleeding, rituximab was given in the 26th week of pregnancy. The platelet count rose to over 100 × 10(9)/L after four weeks. The neonatal B-lymphocyte count normalized at four months after delivery. There were no neonatal complications of rituximab therapy.
Rituximab may be safe for use in treating pregnancy-associated ITP. This case highlights the need to investigate further the safety and efficacy of rituximab in pregnancy.
利妥昔单抗是治疗免疫性血小板减少性紫癜（ITP）的一种新型疗法；然而，关于其在妊娠期安全性的信息有限。本病例说明了成功使用利妥昔单抗治疗妊娠相关性ITP。
一名34岁女性在妊娠23周时出现严重ITP。使用皮质类固醇、静脉注射免疫球蛋白和脾切除术的标准治疗未能提高血小板计数。由于持续出血，在妊娠第26周给予利妥昔单抗。四周后血小板计数升至超过100×10⁹/L。新生儿B淋巴细胞计数在分娩后四个月恢复正常。利妥昔单抗治疗未出现新生儿并发症。
利妥昔单抗用于治疗妊娠相关性ITP可能是安全的。本病例凸显了进一步研究利妥昔单抗在妊娠期安全性和有效性的必要性。
