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The Japanese experience and pharmacokinetics of antenatal maternal high-dose immunoglobulin treatment as a prophylaxis for neonatal hemochromatosis in siblings.
- Source :
- Journal of Maternal-Fetal & Neonatal Medicine; Jan2020, Vol. 33 Issue 1, p142-148, 7p
- Publication Year :
- 2020
-
Abstract
- Background: Neonatal hemochromatosis (NH) is a rare but serious disease causing fulminant hepatic failure. The recurrence rate of NH in a subsequent infant of a mother with an affected infant is 70-90%. Recently, antenatal maternal high-dose intravenous immunoglobulin (IVIG) treatment has been reported to be effective for preventing NH recurrence. However, data on the IgG concentrations during this treatment are limited.Objective: We report a Japanese experience and present a pharmacokinetic simulation model of IgG during IVIG treatment.Methods: Women with histories of pregnancy diagnosed with NH were treated with IVIG weekly from the second trimester until the end of gestation. Serum IgG levels during treatment were collected frequently and pharmacokinetics were simulated by a two-compartment model.Results: Six women were included during eight pregnancies. None experienced severe adverse events. Three out of eight infants showed temporary liver dysfunction, but none required any treatment. A simulation study showed that the estimated trough and peak levels of IgG concentrations during IVIG were 2000-3000 and 4000-5000 mg/dl, respectively.Conclusion: This treatment prevented the recurrence of NH in siblings in Japanese women. We examined the details of serum IgG concentrations and introduced a new pharmacokinetic simulation model of IgG concentrations during IVIG treatment. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEMOCHROMATOSIS
PHARMACOKINETICS
MOTHER-infant relationship
SIBLINGS
LIVER failure
DISEASE relapse prevention
IMMUNOGLOBULINS
INTRAVENOUS therapy
RETROSPECTIVE studies
PREGNANCY outcomes
TREATMENT effectiveness
DISEASE relapse
DOSE-effect relationship in pharmacology
PRENATAL care
CHEMOPREVENTION
REPRODUCTIVE history
Subjects
Details
- Language :
- English
- ISSN :
- 14767058
- Volume :
- 33
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Maternal-Fetal & Neonatal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 139505008
- Full Text :
- https://doi.org/10.1080/14767058.2018.1487940