Failure of immunoglobulins to prevent neonatal thrombocytopenia in mothers with immunothrombocytopenic purpura.
We report the case of a full-term (gestational age: 39 weeks) female newborn of a mother affected by immunothrombocytopenic purpura, treated with a high total dose (2 g/kg) of intravenous IgG, administered over a 3-day period starting 3 days before delivery. Infant platelet count at birth was 20,000/mm3 and she showed a great number of petechiae on the first day of life. After a random donor platelet transfusion and treatment with intravenous high-dose IgG (400 mg/kg for 5 days), platelet count began to increase. We conclude that exogenous IgG, even at high concentrations, apparently does not significantly cross the placenta, despite adequate maternal blood levels.
Zuppa
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Divisione di Neonatologia, Università Cattolica del Sacro Cuore, Policlinico Universitario A. Gemelli, Roma, Italia.
Tornesello
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Mastrangelo
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D001327:Autoimmune Diseases / Q000517:prevention & control*; D005260:Female; D005315:Fetal Diseases / Q000517:prevention & control*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007231:Infant, Newborn; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000517:prevention & control*; D017211:Treatment Failure
D007074:Immunoglobulin G