[A possible "immunologic" origin of idiopathic non-immunologic hydrops fetalis and initial results of preventive immunotherapy of subsequent pregnancies].
The cause of the nonimmune hydrops fetalis remains unsettled in spite of greatest efforts. Under an immunologic point of view of pregnancy as a successful course of an allograft it seems possible, that the idiopathic NIHF can be caused by an immunologic disorder in the meaning of a host-versus-graft-reaction. From 300 cases with prenatal diagnosed NIHF 37 (12.4%) could be classified after exclusion of all other causes as idiopathic and in 25 patients, as well as in 25 age- and parity-paired controls a differentiation of HLA-antigens and a determination of lymphocytotoxic antibodies using the NIH-, Prolonged incubation- and Cold-Complement Dependent-Cytotoxicity-Test (CoCoCy-Test) were performed. In cases with idiopathic NIHF the percentage of parents sharing 4 or 5 HLA-antigens was increased with 4/25 to 2/25 compared to the control group. In women with idiopathic NIHF the incidence of lymphocytotoxic antibodies was decreased, in dependence of the test-system used between 28 and 68% in the NIHF group and 24 and 80% in the control group. The percentage of women without lymphocytotoxic antibodies was increased in the NIHF group with 72% to 52%, in opposite to the control group in none of the patients a higher cytotoxicity with a lysing rate of more than 75% could be detected. In 4 cases with idiopathic NIHF, an increased paternal histocompatibility and a decreased incidence and percentage of lymphocytotoxic antibodies an immunotherapy was performed, in order to induce maternal blocking antibodies.(ABSTRACT TRUNCATED AT 250 WORDS)
Mallmann
P
P
Zentrum für Frauenheikunde und Geburtshilfe der Universität, Bonn.
Gembruch
U
U
Mallmann
R
R
Hansmann
M
M
D000961:Antilymphocyte Serum / Q000032:analysis*; D005260:Female; D006087:Graft vs Host Reaction / Q000235:genetics / Q000276:immunology*; D006680:HLA Antigens / Q000235:genetics*; D006801:Humans; D015160:Hydrops Fetalis / Q000235:genetics / Q000276:immunology* / Q000517:prevention & control; D007116:Immunization, Passive; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012307:Risk Factors
D000961:Antilymphocyte Serum; D006680:HLA Antigens
Untersuchungen zu einer möglichen "immunologischen" Genese des idiopathischen nichtimmunologischen Hydrops fetalis (NIHF) und erste Ergebnisse einer prophylaktischen Immuntherapie nachfolgender Schwangerschaften.