Pregnancy, child bearing and prevention of giving birth to the affected children in patients with primary immunodeficiency disease; A case-series

Sheikhbahaei, S. and Sherkat, R. and Camacho-Ordonez, N. and Khoshnevisan, R. and Kalantari, A. and Salehi, M. and Nazemian, S. S. and Nasr-esfahani, M. H. and Klein, C. (2018) Pregnancy, child bearing and prevention of giving birth to the affected children in patients with primary immunodeficiency disease; A case-series. BMC Pregnancy and Childbirth, 18 (1).

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Abstract

Background: Patients with primary immunodeficiency disease (PID) who survive to adulthood and willing to have a child mostly are worried whether their disease affects their fertility and/or pregnancy and also if their child would be predisposed to PID. Case presentation: We report the outcome of conception, pregnancy and their management in 9 families with definite diagnosis of PID. A chronic granulomatous disease subject with an uneventful pregnancy developed fungal sacral osteomyelitis few weeks after delivery. A pregnant common variable immunodeficiency disease (CVID) patient with idiopathic thrombocytopenia had platelet count dropped before delivery. A sever neutropenic mother who refused to get IFNγ delivered two healthy children. A CVID case intolerant to IVIg with eclampsia and PTE delivered a baby. Another CVID female gave birth to a baby without being on any treatment since she was not diagnosed with immunodeficiency disease at that time. A healthy girl was implanted via preimplantation gender selection in a family who owned a Wiskott Aldrich-affected son. A family who had two children with Ataxia Telangiectasia used donated oocyte for their 3rd child. Prenatal genetic diagnosis was used to screen the fetus for the impaired BTK and CVID genes detected in sibling and father respectively in 2 separate families. Conclusion: Pregnancy in PID patients is more complex than normal population. Because, not only it has the chance of being inherited by the offspring, but also there are some risks for the mother if she has any kind of immunity component defects. So consultation with a clinical geneticist is crucial to choose the best available approach. They also should be observed and followed by a clinical immunologist to take the best possible safe care. © 2018 The Author(s).

Item Type: Article
Additional Information: Cited By :1 Export Date: 16 February 2020 CODEN: BPCMB Correspondence Address: Sherkat, R.; Isfahan University of Medical Science, Acquired Immunodeficiency Research CenterIran; email: sherkat@med.mui.ac.ir
Uncontrolled Keywords: Ataxia telangiectasia CGD Conception CVID Fertility PGD Pregnancy Primary immunodeficiency disease Wiskott-Aldrich alanine aminotransferase alkaline phosphatase antibiotic agent aspartate aminotransferase CD16 antigen CD4 antigen CD8 antigen DNA gamma interferon heparin immunoglobulin immunoglobulin A immunoglobulin E immunoglobulin enhancer binding protein immunoglobulin G immunoglobulin M mycophenolate mofetil prednisone protein p47 transcription factor Cdx1 transmembrane activator and CAML interactor voriconazole adolescent adult alanine aminotransferase blood level alkaline phosphatase blood level allergic reaction Article aspartate aminotransferase blood level Aspergillus fumigatus autoimmune hepatitis birth control blastoma bone infection breast milk bronchiectasis case report case study CDX1 gene celiac disease cesarean section child chorion villus sampling chronic granulomatous disease clinical article common variable immunodeficiency consanguineous marriage contrast enhancement disease course DNA contamination DNA sequence drug withdrawal duodenum biopsy echography eclampsia embryo embryo transfer exon female fetus fibula fracture flow cytometry follicular aspiration follow up fungal osteomyelitis gene mutation gene sequence genetic counseling genetic variability genome analysis gestational age hemoptysis heterozygote hormonal regulation human human cell hypertransaminasemia idiopathic thrombocytopenic purpura immune deficiency immunoglobulin blood level immunoglobulin deficiency infant intracytoplasmic sperm injection JAGN1 gene leukocytosis liver injury low back pain male meningitis nonhuman nuclear magnetic resonance imaging oocyte osteomyelitis p47 phox gene patient care platelet count pneumonia polymerase chain reaction pregnancy outcome recurrent disease respiratory tract infection school child second trimester pregnancy severe congenital neutropenia sex chromosome short tandem repeat stomach cancer third trimester pregnancy TNFRSF13B gene treatment response uterus disease Wiskott Aldrich syndrome X linked agammaglobulinemia young adult birth birth rate complication high risk pregnancy immunology Iran labor complication needs assessment onset age pregnancy complication prenatal care prenatal diagnosis procedures reproductive health standards statistics and numerical data survivor Age of Onset Humans Obstetric Labor Complications Parturition Pregnancy Complications Pregnancy, High-Risk Survivors
Subjects: WC Communicable Diseases
WQ Obstetrics
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 04 May 2020 08:15
Last Modified: 04 May 2020 08:15
URI: http://eprints.mums.ac.ir/id/eprint/17534

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