Female ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; Purpura, Thrombocytopenic, Idiopathic

Since the American Medical Association published the 2011 guidelines for immune thrombocytopenia, China has been the first to update the guidelines for immune thrombocytopenia based on evidence-based medicine. Recently, there have been many breakthroughs in clinical research published, especially the Chinese medical workers have made a prominent contribution to the treatment of the immune thrombocytopenia. However, the references of systematic drug introduction for children, adults, aged and pregnant women are still insufficient, and the first or second line treatment for some patients were ineffective. Therefore, we tried to combine the references to interpret the guidelines, to explore the advantages and disadvantages of each treatment, to find out the bottleneck of clinical treatment, so as to facilitate the implementation and understanding of the guidelines, then update the next guideline.
China ; Female ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; Thrombocytopenia ; United States

Female ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; Purpura, Thrombocytopenic, Idiopathic

Anemia ; epidemiology ; China ; epidemiology ; Female ; Hemoglobins ; analysis ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; epidemiology ; Pregnancy Trimesters

Adult ; Anemia ; Female ; Humans ; Pancytopenia ; Pregnancy ; Pregnancy Complications, Hematologic ; Retrospective Studies ; Thrombocytopenia ; Young Adult

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased vision in her left eye. She had a pale retina with macular edema consistent with BRAO. An extensive workup was performed to determine an etiologic factor. All test results were within normal limits except for her factor VIII activity. Her visual acuity improved from finger counting to 20/30 over 2 months without any treatment. RESULTS: This case suggests that BRAO can occur in healthy patients without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy patients without any systemic or ocular disorders, despite an extensile evaluation.
Adult ; Factor VIII/analysis ; Female ; Humans ; Macular Edema/etiology ; Pregnancy ; *Pregnancy Complications, Hematologic ; Retinal Artery Occlusion/*etiology ; Vision Disorders/etiology

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased vision in her left eye. She had a pale retina with macular edema consistent with BRAO. An extensive workup was performed to determine an etiologic factor. All test results were within normal limits except for her factor VIII activity. Her visual acuity improved from finger counting to 20/30 over 2 months without any treatment. RESULTS: This case suggests that BRAO can occur in healthy patients without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy patients without any systemic or ocular disorders, despite an extensile evaluation.
Adult ; Factor VIII/analysis ; Female ; Humans ; Macular Edema/etiology ; Pregnancy ; *Pregnancy Complications, Hematologic ; Retinal Artery Occlusion/*etiology ; Vision Disorders/etiology

OBJECTIVETo conduct molecular and prenatal diagnosis for a couple with β thalassemia.

METHODSBlood routine examination and hemoglobin analysis were used for screening of thalassemia. Seventeen common Chinese mutations of β thalassemia were detected for the carriers with β thalassemia using PCR/RDB. The unknown mutation of β thalassemia was identified by DNA sequencing and DHPLC analysis.

RESULTSThe husband was heterozygote of CD41/42 (-TCTT). The wife carried a mutation IVS-I-110 (G→A) of β thalassemia having not been reported in Chinese so far. The fetus was a double mutated heterozygote of IVS-I-110 (G→A) and CD41/42 (-TCTT). The pregnancy was terminated.

CONCLUSIONMutation IVS-I-110 (G→A) of β thalassemia in Chinese is of importance to the genetic counseling and prenatal diagnosis of thalassemia.

Base Sequence ; DNA Mutational Analysis ; Female ; Humans ; Male ; Mutation ; Pregnancy ; Pregnancy Complications, Hematologic ; genetics ; Prenatal Diagnosis ; beta-Thalassemia ; diagnosis ; genetics

Objective of this study was to investigate the correlation of body-carried inherited paternal antigens (IPA) in one mother after delivery with pregnancy thrombocytopenia. The changes of platelet (Plt) count in the mother who delivered 2 years ago and her child who is now one year's old were detected, routine tests included Helicobacter pylori, CMV, EBV, parvovirus and other herpes virus's infection were carried out. Eight insertion or deletion sites (InDel) SNP with strong polymorphisms in Chinese population was selected to detect IPA from a genomic library, then primers were designed, the nested PCR and real-time quantitative PCR were used to detect 54 healthy mother-child pairs, the obtained average value was taken as the control, finally two InDel polymorphism sites between mother and child were used to identify the mother/child microchimerism. The IPA of the mother were examined at 4 time points. The results showed that the Plt level of the mother who had suffered thrombocytopenia since 20 weeks after pregnancy reduced to 10 × 10(9)/L. After using gamma globulin, the Plt count increased gradually, but the Plt count decreased rapidly when withdrawal. This patient did not have the infections of virus and Helicobacter pylori. IPA average value of 54 cases were from 10(-5) to 10(-4). At 67 d after delivery, the Plt count of the mother was 14 × 10(9)/L, IPA was 3.45 × 10(-3), which was 30 times higher than the normal. In one month after treatment the IPA was 1.3 × 10(-4) (Plt 256 × 10(9)/L), 5 months later it was 1.2 × 10(-4) (Plt 158 × 10(9)/L), and 6 months later it was 1.5 × 10(-4) (Plt 325 × 10(9)/L). When IPA reached the normal level, the Plt count returned to normal. Her child suffered thrombocytopenia (4 × 10(9)/L) one month after he was born, then recovered after high-dose gamma globulin therapy. It is concluded that abnormal high level IPA may lead to pregnancy thrombocytopenia.
Antigens ; genetics ; Chimerism ; Fathers ; Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications, Hematologic ; genetics ; Thrombocytopenia ; etiology ; genetics

*Cesarean Section ; *Fetal Death ; *Labor Presentation ; *Pregnancy Complications, Hematologic ; *Scotland ; *Umbilical Cord ; *Vital Statistics ; *Infant, Newborn ; *Pregnancy