Ando Yayoi, Kida Michiko, Saika Makoto, Chizuka Aki, Hangaishi Akira, Urabe Akio, Usuki Kensuke
Department of Hematology, NTT Medical Center Tokyo.
Rinsho Ketsueki. 2014 Nov;55(11):2288-93.
We report a 37-year-old pregnant woman with paroxysmal nocturnal hemoglobinuria (PNH) treated with eculizumab. She had been diagnosed with PNH-aplastic anemia at age 19 years, and started to receive eculizumab at age 35 years. Thereafter, she had no hemolytic attacks. She became pregnant 2 years later, and treatment with eculizumab was continued. During her pregnancy, she showed no exacerbation of hemolysis. She delivered a girl by Caesarean section at 37 weeks and 3 days of gestation. Postpartum, anticoagulant therapy was started. Although mild hemolysis and a rise in FDP/Ddimer were seen, she had no symptoms of thrombosis. Ten days after delivery, she and her baby were discharged. Eculizumab was present in the first breast milk and cord blood but was below detectable levels. The cord blood showed blockage of hemolysis.
我们报告了一名37岁接受依库珠单抗治疗的阵发性夜间血红蛋白尿(PNH)孕妇。她19岁时被诊断为PNH-再生障碍性贫血,35岁开始接受依库珠单抗治疗。此后,她没有发生溶血发作。2年后她怀孕了,并继续接受依库珠单抗治疗。孕期,她的溶血没有加重。孕37周零3天时,她剖宫产下一名女婴。产后开始抗凝治疗。虽然出现了轻度溶血以及FDP/D-二聚体升高,但她没有血栓形成的症状。分娩10天后,她和宝宝出院。初乳和脐带血中存在依库珠单抗,但低于可检测水平。脐带血显示溶血受到抑制。