Incidental Finding of Panhypogammaglobulinaemia in Pregnancy-an Extremely Rare Condition

1
Crishan V. Haran
Crishan V. Haran
2
Dr. Sabaratnam Ganeshananthan
Dr. Sabaratnam Ganeshananthan

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GJMR Volume 14 Issue E2
Incidental Finding of Panhypogammaglobulinaemia in Pregnancy-an Extremely Rare Condition

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A 22 year old lady, G2P0 presented at a 311 weeks of gestation with an abnormal group and antibody test found incidentally during routine 28 week blood testing. She reported no past medical history apart from medication controlled gestational diabetes and denied any family history of autoimmune diseases. She was subsequently diagnosed with panhypogam-maglobulinemia. After consultation with an immune-ologist, a number of blood investigations were undertaken, all of which were negative, except for an MRI which showed a possible small thymoma. All fetal ultrasounds were unremarkable. Given the importance of transplacental immunoglobulin (Ig) transfer in the third trimester and the concern of serious infection during pregnancy she has was commenced on intravenous immunoglobulin (IVIg). After a loading dose of IVIg (0.6mg/kg) and a subsequent dose (0.4mg/kg) her Ig level was 10. She was administered a third dose and it was decided that her Ig levels be monitored weekly and IVIg only administered should her levels drop below 7. Since her Ig levels dropped to 6.9g/L at 37 5 weeks of gestation, she received another dose (0.4mg/kg). She underwent a normal delivery at 391 weeks and was diagnosed with a thymoma postnatally.

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References

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  2. Elizabeth Bryan (1977). IgG deficiency in association with placental oedema.
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  8. P Williams,C Leen,A Heppleston,P Yap (1990). IgG Replacement therapy for primary hypogammaglobulinaemia during pregnancy: Report of 9 pregnancies in 4 patients.
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Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

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No ethics committee approval was required for this article type.

Data Availability

Not applicable for this article.

Crishan V. Haran. 2014. \u201cIncidental Finding of Panhypogammaglobulinaemia in Pregnancy-an Extremely Rare Condition\u201d. Global Journal of Medical Research - E: Gynecology & Obstetrics GJMR-E Volume 14 (GJMR Volume 14 Issue E2): .

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Journal Specifications

Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

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v1.2

Issue date

July 20, 2014

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English

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A 22 year old lady, G2P0 presented at a 311 weeks of gestation with an abnormal group and antibody test found incidentally during routine 28 week blood testing. She reported no past medical history apart from medication controlled gestational diabetes and denied any family history of autoimmune diseases. She was subsequently diagnosed with panhypogam-maglobulinemia. After consultation with an immune-ologist, a number of blood investigations were undertaken, all of which were negative, except for an MRI which showed a possible small thymoma. All fetal ultrasounds were unremarkable. Given the importance of transplacental immunoglobulin (Ig) transfer in the third trimester and the concern of serious infection during pregnancy she has was commenced on intravenous immunoglobulin (IVIg). After a loading dose of IVIg (0.6mg/kg) and a subsequent dose (0.4mg/kg) her Ig level was 10. She was administered a third dose and it was decided that her Ig levels be monitored weekly and IVIg only administered should her levels drop below 7. Since her Ig levels dropped to 6.9g/L at 37 5 weeks of gestation, she received another dose (0.4mg/kg). She underwent a normal delivery at 391 weeks and was diagnosed with a thymoma postnatally.

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Incidental Finding of Panhypogammaglobulinaemia in Pregnancy-an Extremely Rare Condition

Crishan V. Haran
Crishan V. Haran
Dr. Sabaratnam Ganeshananthan
Dr. Sabaratnam Ganeshananthan

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