title: Management of immune-mediated cytopenias in pregnancy.
abstract: Immune-mediated cytopenias are a well-described complication of pregnancy. Appropriate recognition and treatment are important in order to limit maternal and fetal morbidity and mortality. First line treatment options are fairly well-established for these entities. Refractory disease may be difficult to manage because treatment choices are limited by known or unestablished risk to the fetus. While the use of new agents, such as romiplostim and rituximab, has been reported, their safety in pregnancy is not known. This article summarizes immune cytopenias seen in pregnant patients, and it also discusses management of these cytopenias, and provides practical strategies for the treatment of these challenging conditions.
authors.affiliation: Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California (USC)/Norris Cancer Center, USC University Hospital, 1441 Eastlake Avenue, Norris Topping Tower 3463, MC 9172, Los Angeles, CA 90033-9172, USA.
authors.forename: Caroline I
authors.initials: CI
authors.lastname: Piatek
authors.affiliation: Princess Noorah Oncology Center MBC-6447, King Abdulaziz Medical City-Western Region, National Guard Health Affairs, PO Box 9515, Jeddah 21423, Saudi Arabia.
authors.forename: Ihab
authors.initials: I
authors.lastname: El-Hemaidi
authors.affiliation: Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California (USC)/Norris Cancer Center, USC University Hospital, 1441 Eastlake Avenue, Norris Topping Tower 3463, MC 9172, Los Angeles, CA 90033-9172, USA.
authors.forename: Donald I
authors.initials: DI
authors.lastname: Feinstein
authors.affiliation: Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California (USC)/Norris Cancer Center, USC University Hospital, 1441 Eastlake Avenue, Norris Topping Tower 3463, MC 9172, Los Angeles, CA 90033-9172, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Liebman
authors.affiliation: Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California (USC)/Norris Cancer Center, USC University Hospital, 1441 Eastlake Avenue, Norris Topping Tower 3463, MC 9172, Los Angeles, CA 90033-9172, USA. Electronic address: mojtaba.akhtari@med.usc.edu.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Akhtari
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000276:immunology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*; D011256:Pregnancy Outcome; D012008:Recurrence; D013921:Thrombocytopenia / Q000150:complications / Q000453:epidemiology / Q000276:immunology* / Q000628:therapy
keywords: Autoimmune hemolytic anemia; Autoimmune neutropenia; Immune thrombocytopenia; Pregnancy; Thrombotic thrombocytopenia purpura