Intravenous immunoglobulin for the secondary prevention of stillbirth in obstetric antiphospholipid syndrome: A case series and systematic review of literature

被引：9

作者：

Urban, Maria Letizia ^{[1
]}

Bettiol, Alessandra ^{[1
,2
]}

Serena, Caterina ^{[3
]}

Comito, Chiara ^{[3
]}

Turrini, Irene ^{[3
]}

Fruttuoso, Silvia ^{[1
]}

Silvestri, Elena ^{[1
]}

Vannacci, Alfredo ^{[2
]}

Ravaldi, Claudia ^{[4
]}

Petraglia, Felice ^{[3
]}

Emmi, Giacomo ^{[1
]}

Prisco, Domenico ^{[1
]}

Mecacci, Federico ^{[3
]}

机构：

[1] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[2] Univ Florence, Dept Neurosci Psychol Drug Res & Child Hlth NEURO, Florence, Italy

[3] Univ Florence, Div Obstet & Gynaecol, Dept Biomed Expt & Clin Sci, Florence, Italy

[4] Univ Florence, Dept Hlth Sci, Florence, Italy

来源：

AUTOIMMUNITY REVIEWS | 2020年 / 19卷 / 09期

关键词：

Obstetric antiphospholipid syndrome; Intravenous immunoglobulin; Stillbirth; Therapy; Pregnancy; PREGNANT PATIENTS; MANAGEMENT; ANTIBODIES; OUTCOMES; WOMEN; HYDROXYCHLOROQUINE; MORBIDITY; MORTALITY; LOSSES; PERIOD;

D O I：

10.1016/j.autrev.2020.102620

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To evaluate the efficacy and safety of intravenous immunoglobulin (IVIg) in secondary prevention of pregnancy complications for patients with obstetric antiphospholipid syndrome (APS) and history of stillbirth. Methods: We described three cases of obstetric APS patients with history of stillbirth treated with IVIg in four pregnancies. In addition, we conducted a systematic literature review on the use of IVIg in obstetric APS with history of stillbirth. Results: Three patients with obstetric APS and history of stillbirth were treated with prophylactic IVIg, in addition to standard treatment (hydroxychloroquine, low-dose aspirin, low molecular weight heparin, and prednisone), in four pregnancies (three singleton and one twin). All pregnancies resulted in live healthy newborns. Long-term follow-up re-evaluations (24-53 months) did not shown any sign or symptom of active systemic disease, and the children were healthy. The systematic literature review retrieved only three cases of use of IVIg in obstetric APS patients with history of stillbirth. All three cases resulted in live healthy newborns. Only in one case, mild thrombocytopenia occurred during treatment, although this event was unlikely to be related to IVIg. Conclusion: Our experience suggests that IVIg as secondary prevention of APS-related stillbirth is associated with good pregnancy and long-term outcomes, with no relevant safety concerns. However, the literature evidence on this topic is limited to few isolated cases, and further studies are needed to clarify which obstetric APS patients may benefit the most from IVIg.

引用

页数：7