Soonchunhyang Med Sci.  2016 Jun;22(1):50-53. 10.0000/sms.2016.22.1.50.

A Successful Planned Pregnancy and Delivery with Eculizumab Maintenance in a Woman with Paroxysmal Nocturnal Hemoglobinuria

• Cho EY
• Kim AJ
• Jung JY
• Ahn JY
• Kim SY
• Lee JH

• KMID: 2328781
• DOI: http://doi.org/10.0000/sms.2016.22.1.50

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by complement-mediated hemolysis leading to severe complications, such as life threatening thrombosis. Eculizumab, a humanized anti-C5 monoclonal antibody, has dramatically improved outcomes of patients with PNH. Despite this new revolutionary treatment, clinical information regarding eculizumab use in pregnant women with PNH is limited. A 30-year-old female with PNH underwent acute aggravation of PNH presented with acute kidney injury (AKI) triggered by an infectious event. After the stabilization of AKI with supportive care and later continuous eculizumab use, a planned pregnancy was attempted and achieved because she and her spouse wanted to have a baby. We monitored the patient carefully throughout her pregnancy with 100 mg/day of aspirin and the maintenance of 900 mg of intravenous eculizumab every 2 weeks. She remained stable during pregnancy and a successful delivery was achieved without maternofetal complication.

Keyword

Hemoglobinuria, paroxysmal; Eculizumab; Pregnancy

MeSH Terms

Acute Kidney Injury
Adult
Aspirin
Family Planning Services*
Female
Hemoglobinuria, Paroxysmal*
Hemolysis
Humans
Pregnancy
Pregnant Women
Spouses
Thrombosis
Aspirin