Multidrug Therapy for Refractory Immune Thrombocytopenia in Pregnancy.
Obstet Gynecol
; 135(3): 723-727, 2020 03.
Article
de En
| MEDLINE
| ID: mdl-32028499
ABSTRACT
BACKGROUND:
Severe immune thrombocytopenia complicating pregnancy may require treatment beyond first-line medications (intravenous immunoglobulins or corticosteroids), but there is a paucity of literature on the use of such second-line agents in pregnancy. CASE The patient is a 29-year-old woman with early-onset severe immune thrombocytopenia at 13 weeks of gestation. Maternal platelet counts reached a nadir of less than 5×10/L. The thrombocytopenia persisted despite first-line medications. Romiplostim, rituximab, and azathioprine were added to the therapeutic regimen. Platelet counts eventually stabilized at greater than 150×10/L before delivery. After delivery at term, the neonate had transient B-cell suppression, which was presumed to be secondary to rituximab, but was otherwise doing well and meeting all milestones at 7 months of age.CONCLUSION:
The addition of second-line agents was associated with sustained elevation in maternal platelet counts and may have obviated the need for splenectomy.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Complications de la grossesse
/
Azathioprine
/
Thrombopoïétine
/
Protéines de fusion recombinantes
/
Récepteur Fc
/
Purpura thrombopénique idiopathique
/
Rituximab
/
Immunosuppresseurs
Limites:
Adult
/
Female
/
Humans
/
Pregnancy
Langue:
En
Journal:
Obstet Gynecol
Année:
2020
Type de document:
Article