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The Use of Intravenous Immunoglobulin in Recurrent Pregnancy Loss Associated With Combined Alloimmune and Autoimmune Abnormalities
Author(s) -
Kiprov Dobri D.,
Nachtigall Robert D.,
Weaver Roderic C.,
Jacobson Arnold,
Main Elliott K.,
Garovoy Marvin R.
Publication year - 1996
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/j.1600-0897.1996.tb00168.x
Subject(s) - medicine , pregnancy , immunology , autoantibody , antibody , autoimmune disease , immune system , abnormality , autoimmunity , immunopathology , psychiatry , genetics , biology
PROBLEM: Several studies have evaluated the effect of intravenous gammaglobulin (IVIG) in women with unexplained recurrent spontaneous abortions (RSA). Data regarding the underlying immunologic abnormalities in these patients is scant. This study reports the pregnancy outcome and immunologic changes observed in a large group of women with RSA associated with well‐defined alloimmune and autoimmune abnormalities treated with IVIG. METHODS: Thirty‐five patients with three or more recurrent miscarriages were studied. None of the patients had identifiable alloimmune response to paternal lymphocytes. Twenty‐four patients had anti‐thyroid antibodies, ten patients had high levels of circulating immune complexes, and six patients had anti‐cardiolipin antibodies. Five patients had Hashimoto's disease, one had immune thrombocytopenic purpura, and one had Crohn's disease. Twenty‐three patients had more than one autoimmune abnormality. All patients received IVIG infusions (200–250 mg/kg) every 3 weeks during the first 8 months of pregnancy. RESULTS: Twenty‐eight patients (80%) had a successful pregnancy. Decrease of the level of autoantibodies and circulating immune complexes was observed in all patients who had a successful pregnancy. Only three of these patients developed measurable alloimmune response to paternal antigens. CONCLUSIONS: This preliminary study suggests that IVIG may be of benefit to patients with recurrent pregnancy loss associated with combined alloimmune and autoimmune abnormalities. This benefit was seen in spite of lack of detectable correction of the alloimmune abnormality in the majority of patients.