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患有常见变异型免疫缺陷且既往对静脉注射免疫球蛋白有反应的孕妇的管理。

Management of a pregnant woman with common variable immunodeficiency and previous reactions to intravenous IgG administration.

作者信息

Danieli Maria Giovanna, Moretti Romina, Pettinari Lucia, Gambini Simona

机构信息

Department of Scienze Cliniche e Molecolari, Clinica Medica, Torrette di Ancona, Italy.

出版信息

BMJ Case Rep. 2012 Dec 17;2012:bcr2012007594. doi: 10.1136/bcr-2012-007594.

Abstract

Common variable immunodeficiency is the most common symptomatic primary immunodeficiency in adulthood. Pregnant women with common variable immunodeficiency have different needs from other patients with the same disease. Because of immature state of the fetal and neonatal immune system, transplacental transfer of immunoglobulin G (IgG) has a relevant role in protecting the infant. We here report on a high-risk pregnant woman with common variable immunodeficiency with adverse reactions to intravenous immunoglobulin that was successfully rescued with a new Ig human intravenous, 10% liquid preparation. The treatment was tailored to the health status and characteristics of the patient. The new product was safe and well tolerated. The mother did not report any infections during pregnancy and the baby had a healthy course with 'protective' serum IgG levels. Our case is a further demonstration that intravenous immunoglobulin tolerability in patients with immunodeficiency could be linked to a product's characteristics.

摘要

普通可变免疫缺陷是成人中最常见的有症状的原发性免疫缺陷。患有普通可变免疫缺陷的孕妇与患有相同疾病的其他患者有不同的需求。由于胎儿和新生儿免疫系统不成熟,免疫球蛋白G(IgG)的胎盘转运在保护婴儿方面具有重要作用。我们在此报告一名患有普通可变免疫缺陷的高危孕妇,她对静脉注射免疫球蛋白有不良反应,通过一种新的10%液体剂型的人源静脉注射免疫球蛋白成功救治。治疗方案是根据患者的健康状况和特点量身定制的。该新产品安全且耐受性良好。母亲在怀孕期间未报告任何感染情况,婴儿发育健康,血清IgG水平处于“保护性”范围。我们的病例进一步证明,免疫缺陷患者对静脉注射免疫球蛋白的耐受性可能与产品特性有关。

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