Autoimmune hemolytic anemia of the cold antibody type associated with pregnancy

Quinlivan, W. Leslie G.; Goldberg, Saul

doi:10.1016/0002-9378(67)90035-x

Cited by 5 publications

(3 citation statements)

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“…1 of the still born infants was severely affected with hae molytic disease [20] but the cause of death in the other was probably not related to the maternal AIH [21].…”

Section: Discussionmentioning

confidence: 99%

“…8 patients with known AIH who became pregnant produced live children in six in stances [10,16,18,19,22]; 2 infants were stillborn [20,21], 2 of the living children [16,18] were mildly affected with haemolytic dis ease and required no treatment. 1 of the still born infants was severely affected with hae molytic disease [20] but the cause of death in the other was probably not related to the maternal AIH [21].…”

Section: Discussionmentioning

confidence: 99%

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Erythrocyte Autoantibodies, Autoimmune Haemolysis and Pregnancy

Sokol¹,

Hewitt²,

Stamps³

1982

Vox Sanguinis

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The clinical and serological records of 20 pregnant patients with erythrocyte autoantibodies were critically reviewed and analysed. This series, the largest reported, confirmed an association between erythrocyte autosensitization and pregnancy, and suggested that this occurred on an average of 1 in 50,000 pregnancies. The clinical presentation varied from severe haemolytic anaemia to serological abnormalities discovered during the routine testing of well patients; overt haemolysis was present in 7 cases. Treatment was only necessary in 3 patients where the haemolysis was severe. 3 infants were mildly affected with haemolytic disease due to the maternal autoantibodies crossing the placenta but no treatment was needed. The risks to the infant were increased when other active autoimmune conditions (e.g., systemic lupus erythematosus) were present. With early diagnosis and appropriate treatment, the outlook for mother and child is good.

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“…1 of the still born infants was severely affected with hae molytic disease [20] but the cause of death in the other was probably not related to the maternal AIH [21].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Erythrocyte Autoantibodies, Autoimmune Haemolysis and Pregnancy

Sokol¹,

Hewitt²,

Stamps³

1982

Vox Sanguinis

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“…Assessment of reports of AIHA in pregnancy published over the past 50 yr is di&cult, particularly for the 1920-45 pre-antiglobulin test era, because evidence for the autoimmune basis of haemolysis is often incomplete. W e have assembled 19 pregnancies occurring in 16 mothers, requiring in each instance that there be unequivocal evidence for acquired haemolysis and wherever possible serologic confirmation of autoimmunity or evidence of a response to corticosteroid therapy (Bateman et al, 1959;Bromberg et al, 1948;Burt & Prichard, 1957;Craig & Turner, 1955;Frumin et al, 1953;Jankelowitz et al, 1960;Mallarm6 et a!, 1965;Osler, 1919;Priofsky, 1969;Quinlivan & Goldberg, 1967;Seip, 1960;Soderhjelm, 1959;Swisher, 1966;Wagner & Maresch, 1955;Wirtheimer, 1956;Witts & Manch, 1932).…”

Section: Previous Reports Of Aiha In Pregnancymentioning

confidence: 99%

Pregnancy and Idiopathic Autoimmune Haemolytic Anaemia: A Prospective Study during 6 Months Gestation and 3 Months Post‐Partum

et al. 1973

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A 31-yr-old woman with a 12 yr history of relapsing idiopathic autoimmune haemolytic anaemia was studied prospectively during her first pregnancy. Her serum contained a warm incomplete autoantibody as well as an elevated cold agglutinin; her red blood cells were strongly coated with IgG and complement (chiefly a2D). Haemolysis was active throughout pregnancy, accelerating from the 34th to 40th week, with developing thrombocytopenia. Amniocentesis in the 8th and 9th months suggested minimal foetal haemolysis. The maternal haemolytic process went into complete clinical remission following delivery of a healthy appearing infant whose red cells were coated with IgG. The infant developed mild hyperbilirubinaemia within 48 hr and experienced a fall in haemoglobin to 50% of the cord level by the 8th week. Abnormalities of maternal and infant C4 levels were observed. Review of 19 reported instances of presumed autoimmune haemolysis during pregnancy revealed life-threatening anaemia in nearly 50% of mothers, with four still-births, one neonatal death, and three seriously affected infants. A programme for prospective management of this serious clinical problem is discussed.Acquired autoimmune haemolytic anaemia (AIHA) is not a rare haematologic disorder; 20-30 patients with this illness are treated annually at the Washington University Medical Center. Approximately 30% of our cases are 'idiopathic'; of these, one-fourth occur in women in the child-bearing second to fifth decades (Allgood& Chaplin, 1967). It is surprising, therefore, that a search of the literature for the past 50 years reveals only 19 reports of pregnancy in patients with presumed AIHA. Among these, seven mothers exhibited a positive direct antiglobulin test; two of these delivered stillborn infants at 6 months gestation, a third infant developed severe anaemia requiring transfusions at 2 mth of age. In none of the reports were the serological findings in mothers and infants characterized in detail or followed in a systematic sequential manner.Recently, a 31-yr-old patient who had been followed by one of the authors (H.C.) for

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