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Sökning: onr:"swepub:oai:lup.lub.lu.se:8315ffeb-7d67-47b8-bbdb-c5b90d4a3f49" > Effect on mother an...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00003847naa a2200409 4500
001oai:lup.lub.lu.se:8315ffeb-7d67-47b8-bbdb-c5b90d4a3f49
003SwePub
008170424s2017 | |||||||||||000 ||eng|
0247 a https://lup.lub.lu.se/record/8315ffeb-7d67-47b8-bbdb-c5b90d4a3f492 URI
0247 a https://doi.org/10.1097/MD.00000000000063382 DOI
040 a (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a Gustavsen, Aliceu Norwegian Radium Hospital4 aut
2451 0a Effect on mother and child of eculizumab given before caesarean section in a patient with severe antiphospholipid syndrome
264 1c 2017
520 a Rationale: Antiphospholipid syndrome (APS) in pregnancy may trigger the life-threatening catastrophic antiphospholipid syndrome (CAPS). Complement activation is implicated in the pathogenesis, and inhibition of complement factor C5 is suggested as an additional treatment option. Patient concerns, diagnosis and interventions: We present a pregnant patient treated with the C5-inhibitor eculizumab due to high risk of developing devastating APS-related complications. The complement inhibitory effects of the treatment were examined both in the patient and the premature infant. Outcomes: Complement activity in the mother recovered considerably faster than anticipated; however, no new thrombosis or CAPS developed during the last week of pregnancy or postpartum. Blood sampling from the umbilical vein and artery, and from the infant after delivery showed low complement activity; however, only 0.3% of the eculizumab concentration detected in the mother, consistent with low placental passage of eculizumab. Lessons: The data underscore the importance of close monitoring of complement inhibition and individualizing dosage regimens in pregnant patients receiving eculizumab. We document how traditional functional complement activity tests cannot assess the effect of eculizumab in premature infants due to the very low levels of complement factors detected in this infant born in gestational week 33. Only trace amounts of eculizumab passed the placenta. In conclusion, complement C5 inhibition might be a safe candidate treatment option for APS during pregnancy and delivery, and additionally, enables prolongation of pregnancy with important weeks.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reproduktionsmedicin och gynekologi0 (SwePub)302202 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Obstetrics, Gynaecology and Reproductive Medicine0 (SwePub)302202 hsv//eng
653 a antiphospholipid syndrome
653 a complement
653 a eculizumab
653 a pregnancy
7001 a Skattum, Lillemoru Lund University,Lunds universitet,Institutionen för laboratoriemedicin,Medicinska fakulteten,Department of Laboratory Medicine,Faculty of Medicine4 aut0 (Swepub:lu)mig-lsk
7001 a Bergseth, Gretheu UiT The Arctic University of Norway, Tromsø4 aut
7001 a Lorentzen, Bjorgu Oslo university hospital4 aut
7001 a Floisand, Yngvaru Oslo university hospital4 aut
7001 a Bosnes, Vidaru Oslo university hospital4 aut
7001 a Mollnes, Tom Eiriku Norwegian Radium Hospital,UiT The Arctic University of Norway, Tromsø,Norwegian University of Science and Technology4 aut
7001 a Barratt-Due, Andreasu Oslo university hospital,Norwegian Radium Hospital4 aut
7102 a Norwegian Radium Hospitalb Institutionen för laboratoriemedicin4 org
7730 t Medicineg 96:11q 96:11x 0025-7974
8564 u http://dx.doi.org/10.1097/MD.0000000000006338x freey FULLTEXT
8564 8u https://lup.lub.lu.se/record/8315ffeb-7d67-47b8-bbdb-c5b90d4a3f49
8564 8u https://doi.org/10.1097/MD.0000000000006338

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