Godano Elisabetta, Barra Fabio, Allodi Alessandra, Ferraiolo Antonella, Laroni Alice, Novi Giovanni, Mancardi Giovanni Luigi, Gustavino Claudio, Arioni Cesare
Neonatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
Ital J Pediatr. 2021 Mar 23;47(1):69. doi: 10.1186/s13052-021-01025-4.
Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women with highly active disease who plan a pregnancy or have an unplanned pregnancy, after accurate counseling about eventual maternal disease relapse due to therapy suspension.
This brief case report describes a case of documented anemia that we observed in a newborn whose mother with relapsing-remitting multiple sclerosis was treated with an extended dosing protocol of natalizumab throughout pregnancy. The newborn received the infusion of erythropoietin every seven days from the fortieth day of life; subsequently, the status of anemia underwent clinical resolution.
This case report confirmed that natalizumab can cause disorders of hematopoiesis, including anemia, thrombocytopenia, or pancytopenia, in newborns of patients treated during pregnancy. A multidisciplinary team, including experienced pediatricians and pediatric hematologists, has a critical role in managing newborns delivered by women, being treated with natalizumab for treating relapsing-remitting multiple sclerosis during pregnancy.
那他珠单抗是一种被批准用于治疗复发缓解型多发性硬化症患者的单克隆抗体。根据目前的临床建议，仅在患有高度活动性疾病且计划怀孕或意外怀孕的女性中，在就因暂停治疗可能导致的母体疾病复发进行准确咨询后，才应仔细评估其在孕期的使用情况。
本简短病例报告描述了一例我们在一名新生儿中观察到的有记录的贫血病例，该新生儿的母亲患有复发缓解型多发性硬化症，在整个孕期接受了那他珠单抗的延长给药方案治疗。该新生儿从出生后第40天起每7天接受一次促红细胞生成素输注；随后，贫血状况通过临床治疗得到缓解。
本病例报告证实，那他珠单抗可导致孕期接受治疗的患者所生新生儿出现造血功能障碍，包括贫血、血小板减少或全血细胞减少。一个多学科团队，包括经验丰富的儿科医生和儿科血液学家，在管理孕期接受那他珠单抗治疗复发缓解型多发性硬化症的女性所分娩的新生儿方面起着关键作用。
