Egawa Makiko, Kanegane Hirokazu, Imai Kohsuke, Morio Tomohiro, Miyasaka Naoyuki
a Department of Pediatrics, Perinatal and Maternal Medicine , Tokyo Medical and Dental University , Tokyo , Japan.
b Department of Pediatrics and Developmental Biology , Tokyo Medical and Dental University , Tokyo , Japan.
J Matern Fetal Neonatal Med. 2019 Sep;32(18):3092-3096. doi: 10.1080/14767058.2018.1455824. Epub 2018 Apr 3.
Immunoglobulin replacement therapy, including intravenous immunoglobulin (IVIG), is essential for pregnant women with common variable immunodeficiency (CVID) since it prevents infection and improves the health of the newborn. There are no established IVIG treatment protocols for pregnant women with CVID, and the relationship between IVIG treatment and maternal serum IgG changes during pregnancy remains unclear. Therefore, we reviewed the medical charts of four CVID patients, including one receiving subcutaneous immunoglobulin (SCIG), for IVIG dose and frequency, maternal serum IgG changes, obstetrical findings, and perinatal outcomes. There were no serious infections but one abortion and all patients continued therapy without IVIG-related adverse events. All eight children born to the patients were healthy at one month. However, the IVIG efficiency in those with CVID significantly decreased with progression of the gestational period, suggesting that IVIG dose and frequency may be changed during pregnancy to maintain stable serum IgG trough levels in women with CVID.
免疫球蛋白替代疗法，包括静脉注射免疫球蛋白（IVIG），对于患有常见可变免疫缺陷（CVID）的孕妇至关重要，因为它可以预防感染并改善新生儿的健康状况。目前尚无针对患有CVID的孕妇的既定IVIG治疗方案，并且IVIG治疗与孕期母体血清IgG变化之间的关系仍不清楚。因此，我们回顾了4例CVID患者的病历，其中1例接受皮下免疫球蛋白（SCIG）治疗，分析了IVIG剂量和频率、母体血清IgG变化、产科检查结果及围产期结局。未发生严重感染，但有1例流产，所有患者均继续治疗，未出现与IVIG相关的不良事件。患者所生的8名儿童在1个月时均健康。然而，随着妊娠期进展，CVID患者的IVIG疗效显著降低，这表明在孕期可能需要改变IVIG剂量和频率，以维持CVID女性稳定的血清IgG谷值水平。
