Acute leukemia during pregnancy. Association with immune-mediated thrombocytopenia in mother and infant.
A 29-year-old female in the 20th week of pregnancy was admitted because of a change in the ABO blood group and bleeding tendency. Acute myelogenous leukemia was diagnosed with a weak reaction of red blood cells with anti-A antibody and a decreased level of A-transferase activity. Though the patient tolerated intensive chemotherapy and achieved complete remission, thrombocytopenia persisted after consolidation chemotherapy. Since platelet-associated IgG was elevated, thrombocytopenia was considered to be immune-mediated. In the third trimester, premature separation of the normally implanted placenta developed and cesarean section was performed. The male baby was also thrombocytopenic, but successfully treated with gamma-globulin.
Division of Internal Medicine, Sanshinkai Hara Hospital, Fukuoka, Japan.
H
H
Gondo
Y
Y
Hamasaki
H
H
Nakayama
T
T
Kondo
J
J
Mitsuuchi
Y
Y
Kawaga
S
S
Taniguchi
M
M
Harada
Y
Y
Niho
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000188:drug therapy; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology* / Q000628:therapy; D011252:Pregnancy Complications, Neoplastic / Q000097:blood* / Q000188:drug therapy; D011263:Pregnancy Trimester, Third; D013921:Thrombocytopenia / Q000151:congenital / Q000209:etiology* / Q000628:therapy; D005719:gamma-Globulins / Q000627:therapeutic use
D005719:gamma-Globulins