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Clin Dev Immunol. 2008;2008:271363. doi: 10.1155/2008/271363.

Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development.

Author information

1
Department of Neonatology, VU University Medical Center, De Boelelaan 1117, 1018 HV Amsterdam, The Netherlands.

Abstract

We describe the effect on the neonate of administration of rituximab to a woman with idiopathic thrombocytopenic purpura (ITP). Rituximab, an anti-CD20 antibody, was given weekly for 4 weeks to a woman with ITP in her third trimester of pregnancy. One month after the last rituximab administration a healthy girl was born. She had normal growth and development during the first six months. At birth, B-lymphocytes were not detectable. Rituximab levels in mother and neonate were 24000 and 6700 ng/mL, respectively. Only 7 cases of rituximab administration during pregnancy were described. No adverse events are described for fetus and neonate. We demonstrate that rituximab passes the placenta and inhibits neonatal B-lymphocyte development. However, after 6 months B-lymphocyte levels normalized and vaccination titres after 10 months were adequate. No infection-related complications occurred. Rituximab administration during pregnancy appears to be safe for the child but further studies are warranted.

PMID:
18596903
PMCID:
PMC2438602
DOI:
10.1155/2008/271363
[Indexed for MEDLINE]
Free PMC Article

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