Management of a pregnant woman with common variable immunodeficiency and previous reactions to intravenous IgG administration

Abstract

Common variable immunodeficiency is the most common symptomatic primary immunodeficiency in adulthood. Pregnant women with common variable immunodeficiency have different needs from other patients with the same disease. Because of immature state of the fetal and neonatal immune system, transplacental transfer of immunoglobulin G (IgG) has a relevant role in protecting the infant. We here report on a high-risk pregnant woman with common variable immunodeficiency with adverse reactions to intravenous immunoglobulin that was successfully rescued with a new Ig human intravenous, 10% liquid preparation. The treatment was tailored to the health status and characteristics of the patient. The new product was safe and well tolerated. The mother did not report any infections during pregnancy and the baby had a healthy course with ‘protective’ serum IgG levels. Our case is a further demonstration that intravenous immunoglobulin tolerability in patients with immunodeficiency could be linked to a product's characteristics.

A case report of pregnancy in a patient with common variable immunodeficiency emphasizing the need for personalized immunoglobulin replacement

“…However, despite medical advantages SCIg might not be accepted by some patients. Danieli et al [ 12 , 13 ] described a 36-year-old woman with CVID, a high risk pregnancy and severe adverse reactions to IVIg who refused SCIg and preferred to be treated intravenously. Our patient had been offered conventional SCIg treatment but found the weekly home self-infusions too burdensome.…”