rituximab administration in third trimester of pregnancy suppresses neonatal b-cell development美罗华政府在晚期妊娠的抑制新生儿b细胞的发展.pdf

Hindawi Publishing Corporation Clinical and Developmental Immunology Volume 2008, Article ID 271363, 6 pages doi:10.1155/2008/271363 Case Report Rituximab Administration in Third Trimester of Pregnancy Suppresses Neonatal B-Cell Development D. T. Klink,1 R. M. van Elburg,1 M. W. J. Schreurs,2 and G. T. J. van Well3, 4 1 Department of Neonatology, VU University Medical Center, De Boelelaan 1117, 1018 HV Amsterdam, The Netherlands 2 Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1018 HV Amsterdam, The Netherlands 3 Department of Paediatrics and Infectious Diseases, VU University Medical Center, De Boelelaan 1117, 1018 HV Amsterdam, The Netherlands 4 Department of Paediatrics, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands Correspondence should be addressed to R. M. van Elburg, rm.vanelburg@vumc.nl Received 14 January 2008; Accepted 5 May 2008 Recommended by Mario Clerici We describe the effect on the neonate of administration of rituximab to a woman with idiopathic thrombocytopenic purpura (ITP). Rituximab, an anti-CD20 antibody, was given weekly for 4 weeks to a woman with ITP in her third trimester of pregnancy. One month after the last rituximab administration a healthy girl was born. She had normal growth and development during the first six months. At birth, B-lymphocytes were not detectable. Rituximab levels in mother and neonate were 24000 and 6700 ng/mL, respectively. Only 7 cases of rituximab administration during pregnancy were described. No adverse events are described for fetus and neonate. We demonstrate that rituximab passes the placenta and inhibits neonatal B-lymphocyte development. However, after 6 months B-lymphocyte levels normalized and vaccination titres after 10 month