Common variable immunodeficiency (Set of case reports)

Czech version

Authors: B. Kuřecová ¹; Petr Janků ¹; J. Litzman ²
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc. ¹; Ústav klinické imunologie a alergologie LF MU a FN u sv. Anny, Brno, přednosta prof. MUDr. J. Litzman, CSc. ²
Published in: Ceska Gynekol 2009; 74(3): 197-201

Overview

Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immunodeficiency, which is characterized by impaired antibody responses. It’s manifestation includes mainly severe and recurrent bacterial infections affecting predominantly upper and lower respiratory tract. Because of the improved standard of hypogammaglobulinemic patients many affected females become pregnant. When a woman treated for CVID gets pregnant the adequate treatment is necessary not only to protect patient from infections, but also to allow suffitient transfer of IgG through the placenta to supply the fetus and consequently the newborn. Regular periodic replacement therapy with intravenous immunoglobulins (IVIG) is applied in pregnant women as well as in other hypogammaglobulinemic patients. Regimen of IVIG administration must be modified in order to reach satisfactory IgG levels in the newborns’ blood. Here we present a set of case reports of five pregnant women with CVID treated by immunoglobulins during pregnancy. In all cases labor was induced in term after the last IVIG infusion. The mode of delivery depended on the obstetric indication. All pregnancies resulted in healthy newborns.

Key words:
immunoglobulins, primary immunodeficiency, common variable immunodeficiency, pregnancy, labor.

Sources

1. Bartůňková, J., Šedivá, A., Janda, A. Imunodeficience. 2. přepracované a doplněné vyd., Praha: Grada publishing, 2007.

2. Fait, G., Gull, I., Kupferminc, MJ., et al. Fever in a pregnant woman with common variable immunodeficiency. J Obstet Gynaecol, 1998, 18, 2, p. 88-189.

3. Hansen, S., Gardulf, A., Andersson, E., et al. Women with primary antibody deficiences requiring IgG replacement therapy: their perception of prenatal care dutiny pregnancy. JOGNN, 2004, 33, 5, p. 604-609.

4. Hořejší, V., Bartůňková, J. Základy imunologie, 2. vyd. Praha: Triton, 2001.

5. Park, MA., Li, JT., Hagan, JB., et al. Common variable immunodeficiency: a new look at an old disease. Lancet, 2008, 372, 9637, p. 489-502.

6. Sewell, WA., Buckland, M., Jolles, SR. Drugs, 2003, 63, 13, p. 1359-1371.

7. Shalev, E., Ben-Ami, M., Peleg, D. Common variable hypogammaglobulinemia in pregnancy. Brit J Obstet Gynaecol, 1993, 100, p. 1138-1139.

8. Vitoratos, N., Bakas, P., Kalampani, H., Creatsas, G. Maternal common variable immunodeficiency and pregnancy. J Obstet Gynaecol, 1999, 19, 6, p. 654-655.