title: Rituximab for management of refractory pregnancy-associated immune thrombocytopenic purpura.
abstract: BACKGROUND
  Rituximab is a novel therapy for immune thrombocytopenic purpura (ITP); however, information about its safety in pregnancy is limited. This case illustrates the successful use of rituximab to treat pregnancy-associated ITP.
  
  
  METHODS
  A 34-year-old woman presented with severe ITP at 23 weeks' gestation. Standard treatment with corticosteroids, intravenous immune globulin, and splenectomy failed to raise the platelet count. Due to ongoing bleeding, rituximab was given in the 26th week of pregnancy. The platelet count rose to over 100 × 10(9)/L after four weeks. The neonatal B-lymphocyte count normalized at four months after delivery. There were no neonatal complications of rituximab therapy.
  
  
  CONCLUSIONS
  Rituximab may be safe for use in treating pregnancy-associated ITP. This case highlights the need to investigate further the safety and efficacy of rituximab in pregnancy.
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Brent
authors.initials: B
authors.lastname: Gall
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Adrian
authors.initials: A
authors.lastname: Yee
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Brian
authors.initials: B
authors.lastname: Berry
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bircham
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Allen
authors.initials: A
authors.lastname: Hayashi
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Jerome
authors.initials: J
authors.lastname: Dansereau
authors.affiliation: Faculty of Medicine, University of British Columbia Vancouver BC.
authors.forename: Jason
authors.initials: J
authors.lastname: Hart
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000188:drug therapy*; D000069283:Rituximab; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000175:diagnosis
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab