K článku Běžný variabilní imunodeficit v těhotenství (soubor kazuistik)

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Published in: Ceska Gynekol 2010; 75(2): 159
Category: Letters to the Editor

Correspondence to: Luis Ignacio Gonzalez-Granado. Immunodeficiencies Unit. Hospital 12 octubre. Carretera Andalucia km 5,400. Madrid. Spain. Email to: nachgonzalez@gmail.com

Dear sir,

thank you for your comment on immunoglobulin replacement treatment in pregnant patients with hypogammaglobulinaemia. We fully agree that subcutaneous immunoglobulin (SCIg) replacement is a good alternative to intravenous administration. Unfortunately subcutaneous derivates had not been not available in the Czech Republic till 2006, and only in the last two years our market became relatively well supplied. In other words the Czech Republic is in the process of changing intravenous treatment into subcutaneous. That is also the explanation why none of our patients described in our paper you were treated by SCIg.

At present approximately one forth of our hypogammaglobulinaemic patients are on SCIg and we gradually increase this proportion. In the case if any of these patients becomes pregnant, we will probably continue with the subcutaneous route of immunoglobulin administration. Certainly, your good experience and also the studies you have mentioned in your letter, will support this approach.

Litzman J, Kuřecová B, Janků P.

Sources

1. Kurecová, B., Janků, P., Litzman, J. Common variable immunodeficiency in pregnancy (set of case reports). Ces Gynek 2009;74(3):197-201.

2. Gustafson, R., Gardulf, A., Hansen, S., et al. Rapid subcutaneous immunoglobulin administration every second week results in high and stable serum immunoglobulin G levels in patients with primary antibody deficiencies. Clin Exp Immunol 2008;152(2):274-279.

3. Berger, M., Cupps, TR., Fauci, AS. High-dose immunoglobulin replacement therapy by slow subcutaneous infusion during pregnancy. JAMA1982;247(20):2824-2825.

4. Gardulf, A., Andersson, E., Lindqvist, M., Hansen, S., Gustafson, R. Rapid subcutaneous IgG replacement therapy at home for pregnant immunodeficient women. J Clin Immunol 2001;21:150-154.