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Rh (D) alloimmunization treated by double filtration plasmapheresis.

Sibel Gokcay Bek1, Necmi Eren1, Ant Uzay2

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Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
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PubMed
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Double filtration plasmapheresis (DFPP) effectively managed a pregnant patient with anti-D antibodies, ensuring a stable antibody titer. This treatment led to a successful delivery, highlighting DFPP as a safe option for red cell alloimmunization in pregnancy.

Keywords:
Double plasmapheresisPregnancyRh alloimmunization

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Area of Science:

  • Obstetrics and Gynecology
  • Immunology
  • Transfusion Medicine

Background:

  • Red cell alloimmunization during pregnancy poses risks to fetal well-being.
  • Anti-D antibodies can cause hemolytic disease of the fetus and newborn.
  • Management often involves monitoring antibody titers and considering interventions.

Observation:

  • A 31-year-old pregnant woman presented with a positive serum antiglobulin test indicating anti-D antierythrocyte antibodies.
  • Treatment with double filtration plasmapheresis (DFPP) was initiated early in pregnancy.
  • Intravenous immunoglobulin therapy was administered concurrently.

Findings:

  • Double filtration plasmapheresis successfully maintained the patient's antierythrocyte antibody titer below a stable level of 1:64.
  • The patient delivered successfully at 30 weeks of gestation.
  • The fetus did not experience significant complications related to alloimmunization.

Implications:

  • Double filtration plasmapheresis (DFPP) demonstrates efficacy and safety in managing pregnant women with red cell alloimmunization.
  • This case supports DFPP as a viable therapeutic option to improve pregnancy outcomes in alloimmunized patients.
  • Further research into DFPP for alloimmunization in pregnancy is warranted.