title: [Successful therapeutic management of risk pregnancy in primary Sjögren syndrome with plasmapheresis and dexamethasone].
abstract: We describe a 28-year-old woman with primary Sjögren's syndrome who had a miscarriage in the 10th week of gestation in December 1993. In her second pregnancy plasma hyperviscosity and high antibody reactivities to 52/60 kD Ro(SS-A) and La(SS-B) represented elevated risk factors for abortion and fetal congenital heart block. Therefore, we performed plasmapheresis and administered dexamethason. At the end of 37th week of gestation a healthy boy was born by caesarean operation. Interestingly, antibody levels to the anti-Ro(SS-A)/La(SS-B) complex showed an increase during both pregnancies with a decline after the abortion as well as the partus. The combined therapy led to a decrease in both the autoantibody reactivities to 52 kD Ro(SS-A) and La(SS-B) and the plasmaviscosity. Plasmapheresis and dexamethason are safe treatment modalities in identified high risk pregnancies for the birth of a child with CHB.
authors.affiliation: Medizinische Universitätsklinik und Poliklinik III, Universitätsklinikum Charité, Humboldt-Universität zu Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Feist
authors.forename: T
authors.initials: T
authors.lastname: Dörner
authors.forename: A
authors.initials: A
authors.lastname: Wagenmann
authors.forename: R
authors.initials: R
authors.lastname: Chaoui
authors.forename: W
authors.initials: W
authors.lastname: Rohde
authors.forename: G R
authors.initials: GR
authors.lastname: Burmester
authors.forename: F
authors.initials: F
authors.lastname: Hiepe
mesh_terms: D000030:Abortion, Missed / Q000000981:diagnostic imaging / Q000276:immunology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001323:Autoantibodies / Q000097:blood; D001809:Blood Viscosity / Q000276:immunology; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010956:Plasmapheresis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000628:therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012859:Sjogren's Syndrome / Q000276:immunology / Q000628:therapy*; D016216:Ultrasonography, Prenatal
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D003907:Dexamethasone
vernacular_title: Erfolgreiches therapeutisches Management einer Risikoschwangerschaft bei primärem Sjögren-Syndrom mit Plasmapherese und Dexamethason.