title: Autoimmune and pregnancy complications in the daughter of a kidney transplant patient.
abstract: BACKGROUND
  Immunosuppressive agents taken by pregnant organ transplant recipients readily cross the placenta during development of the fetal immune system. There are few data on the long-term implications for the progeny, but evidence from animal studies suggest that second and third generations of organ transplant patients may be at risk for autoimmune disorders and reproductive problems.
  
  
  METHODS
  We present the 23-year-old daughter of a renal allograft recipient exposed to azathioprine 75 mg/day and prednisone 5 mg/day throughout her mother's pregnancy.
  
  
  RESULTS
  During the daughter's first pregnancy, she developed multiple autoantibodies, Raynaud's phenomenon, and fetal death occurred at 20 weeks gestation. The second pregnancy was complicated by systemic lupus erythematosus, preeclampsia, and the birth of a preterm male infant.
  
  
  CONCLUSIONS
  It is uncertain whether the autoimmune manifestations and obstetric complications in this patient were related to fetal exposure to immunosuppressive drugs. Nevertheless, further studies on the health and pregnancies of adult offspring of transplant patients are warranted.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City, UT 84132, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Scott
authors.forename: D Ware
authors.initials: DW
authors.lastname: Branch
authors.forename: John
authors.initials: J
authors.lastname: Holman
mesh_terms: D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000209:etiology*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents