[Immune thrombocytopenia, anemia and leukopenia during pregnancy. Successful therapy with extracorporeal immunoadsorption]

Dtsch Med Wochenschr. 1997 Feb 21;122(8):220-4. doi: 10.1055/s-2008-1047600.
[Article in German]


History and clinical findings: A 28-year-old woman in her fourth pregnancy had a positive direct Race-Coombs test in her 14th week of pregnancy. About 6 weeks later she developed marked anaemia, severe thrombocytopenia and leukopenia with nose-bleeds as well as petechiae over the lower abdomen and the inguinal regions.

Investigations: Platelet count was 7000/microliter, haemoglobin concentration 4.8 mmol/l (7.73 g/dl) and WBC count 2600/microliter). Bleeding time was markedly prolonged. Erythrocyte-attached immunoglobulin G and complement components as well as antithrombocyte and antigranulocyte antibodies were demonstrated. Haemoblastosis or aplastic anaemia was excluded by bone marrow examination.

Treatment and course: The pancytopenia with immune thrombocytopenia, autohaemolytic anaemia and associated leukopenia were classified as Evans syndrome. Administration of glucocorticoids and of immunoglobulins intravenously for 5 days failed to improve the blood picture significantly. But platelet count rose significantly on immunoadsorption (Ig Therasorb columns), allowing the pregnancy to proceed.

Conclusion: In life-threatening states Ig immunoadsorption can achieve well tolerated, effective and specific elimination of pathogenetically relevant antibodies against blood cells and can also be applied in pregnant women.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Anemia, Hemolytic, Autoimmune / complications
  • Anemia, Hemolytic, Autoimmune / therapy*
  • Autoantibodies / blood
  • Autoimmune Diseases / therapy*
  • Complement C3 / analysis
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunosorbent Techniques
  • Leukopenia / complications
  • Leukopenia / therapy*
  • Pregnancy
  • Pregnancy Complications, Hematologic / therapy*
  • Renal Dialysis
  • Thrombocytopenia / complications
  • Thrombocytopenia / therapy*


  • Autoantibodies
  • Complement C3
  • Immunoglobulin G