Lin Eena Sunya, Afridi Faraz, Mysore Sukrita Sheshu, Presenza Thomas, Kushnir Alla, Ahmed Rafat
Cooper Medical School of Rowan University, Camden, New Jersey.
Department of Pediatric Hematology-Oncology, MD Anderson Children's Cancer Hospital, Houston, Texas.
AJP Rep. 2025 Jan 7;15(1):e1-e5. doi: 10.1055/a-2496-8690. eCollection 2025 Jan.
Gestational alloimmune liver disease (GALD) is characterized by maternal IgG-directed fetal hepatocyte damage and can lead to severe liver failure and fetal or infant death. Moreover, GALD is associated with a near 90% risk of recurrence in subsequent pregnancies. We present a case of a newborn patient delivered to a 32-year-old G2P1000 mother who received prolonged antenatal intravenous immunoglobulin (IVIG) treatment during the current pregnancy due to the neonatal death of the first child from GALD-related liver failure. Postnatal testing, including a liver magnetic resonance imaging (MRI) and buccal biopsy of this newborn, showed normal morphology of the liver without any abnormal iron deposition. Additional laboratory testing showed a lack of any liver injury. This case supports the use of antenatal IVIG immunotherapy to prevent the recurrence of GALD in subsequent pregnancies. GALD can lead to severe fetal liver injury.GALD is highly recurrent in subsequent pregnancies.Prophylactic IVIG may prevent GALD recurrence.
妊娠同种免疫性肝病（GALD）的特征是母体IgG介导的胎儿肝细胞损伤，可导致严重肝功能衰竭及胎儿或婴儿死亡。此外，GALD在随后的妊娠中有近90%的复发风险。 我们报告一例新生儿病例，其母亲为32岁经产妇（G2P1000），因第一个孩子死于GALD相关肝功能衰竭，此次妊娠期间接受了长时间的产前静脉注射免疫球蛋白（IVIG）治疗。对该新生儿进行的产后检查，包括肝脏磁共振成像（MRI）和颊部活检，显示肝脏形态正常，无任何异常铁沉积。进一步的实验室检查显示无任何肝损伤。 该病例支持使用产前IVIG免疫疗法预防GALD在随后妊娠中的复发。GALD可导致严重的胎儿肝损伤。GALD在随后的妊娠中极易复发。预防性IVIG可能预防GALD复发。
