Maternal hemolysis after intravenous immunoglobulin treatment in fetal and neonatal alloimmune thrombocytopenia.
BACKGROUND
Intravenous immunoglobulin (IVIG) is a therapeutic agent used to prevent fetal thrombocytopenia in those pregnancies identified to be at risk for fetal and neonatal alloimmune thrombocytopenia. Although generally considered a safe medication, hemolytic anemia is a known side effect of IVIG treatment that may result in maternal medical complications.


METHODS
We present three cases of IVIG-induced maternal anemia from separate institutions that occurred during treatment for fetal and neonatal alloimmune thrombocytopenia and resolved after discontinuation or alteration of therapy. None of the treated fetuses had thrombocytopenia at birth.


CONCLUSIONS
There is a potential for hemolysis when prescribing IVIG. We recommend laboratory monitoring for hemolytic anemia and suggest options for management including drug modification or cessation of therapy.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The Ohio State University, Columbus, Ohio 43210, USA. britton.rink@osumc.edu
Britton D
BD
Rink
Bernard
B
Gonik
Ramen H
RH
Chmait
Richard
R
O'Shaughnessy
D000328:Adult; D000740:Anemia / Q000139:chemically induced* / Q000628:therapy; D005260:Female; D005315:Fetal Diseases / Q000517:prevention & control*; D006461:Hemolysis; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000139:chemically induced* / Q000628:therapy; D013921:Thrombocytopenia / Q000517:prevention & control*
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors