title: Managing a pregnant patient with paroxysmal nocturnal hemoglobinuria in the era of eculizumab.
abstract: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal stem cell disorder, which affects women of child-bearing age. PNH is associated with thrombotic complications, which are the main causes of morbidity and mortality. Management of a pregnant woman with PNH remains a challenge due to high incidence of thrombotic complications and the difficulty of differentiating a PNH crisis from the complications of pregnancy. PNH is associated with an increased rate of premature labor and fetal loss. Eculizumab, a humanized monoclonal antibody directed against the terminal complement protein C5, has revolutionized treatment of PNH. However, the role of eculizumab in pregnancy is unclear. We review the current strategies for the management of pregnant women with PNH, underline the controversies and present our recommendations.
authors: Department of Hematology and Oncology, Tufts Medical Center, 800 Washington St, Boston, MA 02111, USA.
authors: Alexey V
authors: AV
authors: Danilov
authors: Robert A
authors: RA
authors: Brodsky
authors: Sabrina
authors: S
authors: Craigo
authors: Hedy
authors: H
authors: Smith
authors: Kenneth B
authors: KB
authors: Miller
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; C481642:eculizumab