Treatment with plasmapheresis and intravenous immunoglobulin in pregnancies complicated with anti-PP1Pk or anti-K immunization: a report of two patients
Article first published online: 7 JUL 2008
Volume 80, Issue 2, pages 117–120, February 2001
How to Cite
Fernández-Jiménez, M. C., Jiménez-Marco, M. T., Hernández, D., González, A., Omeñaca, F. and De La Cámara, C. (2001), Treatment with plasmapheresis and intravenous immunoglobulin in pregnancies complicated with anti-PP1Pk or anti-K immunization: a report of two patients. Vox Sanguinis, 80: 117–120. doi: 10.1046/j.1423-0410.2001.00021.x
- Issue published online: 7 JUL 2008
- Article first published online: 7 JUL 2008
- Received: 23 February 2000, revised 19 October 2000, accepted 9 November 2000
- haemolytic disease of the newborn;
- Kell alloimmunization;
Background and Objectives
In addition to anti-D alloantibody, other antibodies such as anti-K antibody and anti-PP1Pk antibody have been reported to cause severe haemolytic disease of the newborn (HDN). HDN caused by anti-K results not only from destruction of red cells but also from suppression of erythropoiesis. Anti-PP1Pk has been associated with abortion early in pregnancy. We report on two patients, one with anti-PP1Pk and the other with anti-K, who were treated with plasmapheresis and intravenous immunoglobulin (IVIG) during pregnancy in an attempt to reduce the plasma antibody levels.
Materials and Methods
The patient with anti-PP1Pk had lost all seven previous fetuses in the first trimester and therefore therapy in this patient was started at 8 weeks of gestation. The second patient had been sensitized to the K antigen through blood transfusion and had had two intrauterine fetal deaths at 26 weeks of gestation with signs of hydrops fetalis. Treatment in this patient was started during the 16th week of pregnancy.
As a result of therapy, the antibody titre was reduced in both patients. In the first patient a healthy infant was delivered by Caesarean section at 37 weeks of gestation. The second patient gave birth at 36 weeks of gestation. Neither newborn required exchange transfusion.
In our two patients, plasmapheresis combined with IVIG proved successful in the management of fetomaternal incompatibilities where the mechanism of fetal loss differs from the classical anti-D.