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dc.contributor.authorGustavsen, Alice
dc.contributor.authorSkattum, Lillemor
dc.contributor.authorBergseth, Grete
dc.contributor.authorLorentzen, Bjørg
dc.contributor.authorFløisand, Yngvar
dc.contributor.authorBosnes, Vidar
dc.contributor.authorMollnes, Tom Eirik
dc.contributor.authorBarratt-Due, Andreas
dc.date.accessioned2017-11-08T09:03:21Z
dc.date.available2017-11-08T09:03:21Z
dc.date.created2017-08-04T12:36:12Z
dc.date.issued2017
dc.identifier.citationMedicine (Baltimore, Md.). 2017, 96 (11), .nb_NO
dc.identifier.issn0025-7974
dc.identifier.urihttp://hdl.handle.net/11250/2464817
dc.description.abstractRationale: Antiphospholipid syndrome (APS) in pregnancy may trigger the life-threatening catastrophic antiphospholipid syndrome (CAPS). Complement activation is implicated in the pathogenesis, and inhibition of complement factor C5 is suggested as an additional treatment option. Patient concerns, diagnosis and interventions: We present a pregnant patient treated with the C5-inhibitor eculizumab due to high risk of developing devastating APS-related complications. The complement inhibitory effects of the treatment were examined both in the patient and the premature infant. Outcomes: Complement activity in the mother recovered considerably faster than anticipated; however, no new thrombosis or CAPS developed during the last week of pregnancy or postpartum. Blood sampling from the umbilical vein and artery, and from the infant after delivery showed low complement activity; however, only 0.3% of the eculizumab concentration detected in the mother, consistent with low placental passage of eculizumab. Lessons: The data underscore the importance of close monitoring of complement inhibition and individualizing dosage regimens in pregnant patients receiving eculizumab. We document how traditional functional complement activity tests cannot assess the effect of eculizumab in premature infants due to the very low levels of complement factors detected in this infant born in gestational week 33. Only trace amounts of eculizumab passed the placenta. In conclusion, complement C5 inhibition might be a safe candidate treatment option for APS during pregnancy and delivery, and additionally, enables prolongation of pregnancy with important weeks. Abbreviations: APS = antiphospholipid syndrome, CAPS = catastrophic antiphospholipid syndrome, E-C5 = eculizumab-C5, EDTA = ethylenediaminetetraacetic acid, IgG = immunoglobulin G.nb_NO
dc.language.isoengnb_NO
dc.publisherLippincott, Williams & Wilkinsnb_NO
dc.rightsAttribution-NoDerivatives 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nd/4.0/deed.no*
dc.titleEffect on mother and child of eculizumab given before caesarean section in a patient with severe antiphospholipid syndromenb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.source.pagenumber4nb_NO
dc.source.volume96nb_NO
dc.source.journalMedicine (Baltimore, Md.)nb_NO
dc.source.issue11nb_NO
dc.identifier.doi10.1097/MD.0000000000006338
dc.identifier.cristin1484204
dc.description.localcodeCopyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.nb_NO
cristin.unitcode194,65,15,0
cristin.unitnameInstitutt for klinisk og molekylær medisin
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1


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Attribution-NoDerivatives 4.0 Internasjonal
Med mindre annet er angitt, så er denne innførselen lisensiert som Attribution-NoDerivatives 4.0 Internasjonal