View in EDS

Septic Episodes in a Premature Infant After In Utero Exposure to Rituximab.

Saved in:
Bibliographic Details
Title: Septic Episodes in a Premature Infant After In Utero Exposure to Rituximab.
Authors: Hay, Susanne, Burchett, Sandra, Odejide, Oreofe, Cataltepe, Sule
Source: Pediatrics. Sep2017, Vol. 140 Issue 3, pe1-e5. 5p.
Subjects: Differential diagnosis, Cord blood, Premature infants, Rituximab, Sepsis, Diagnosis
Abstract: Rituximab is an increasingly used immunotherapeutic agent for women of reproductive age for treatment of autoimmune diseases, leukemias, and lymphomas. Rituximab is a chimeric monoclonal antibody that targets B-cell surface antigen CD20 and can cross the placenta. Current evidence of the impact of this medication on the developing fetus is limited, but there is little to suggest that fetal exposure to this medication places an infant at increased risk of immunosuppression and subsequent infection. Here we report a case of in utero rituximab exposure that was associated with 2 severe septic episodes with Enterococcus faecalis, in a premature infant of 29 weeks' gestational age with a birth weight of 820 g. The patient had a critically depressed B-lymphocyte subset of 10% and undetectable immunoglobulin (Ig)G, IgM, and IgA levels at 37 weeks' postmenstrual age. Interestingly, both episodes of sepsis coincided with transition from donor human milk to formula feeds. She was treated with intravenous immunoglobulin, antibiotics, and donor human milk. We postulate that placental transfer of rituximab, prematurity, and the low levels of protective maternal antibodies increased the susceptibility of this patient to sepsis by E faecalis, a resident of the normal gut flora, whereas the secretory IgA in donor human milk may have played a protective role. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 125093997
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Septic Episodes in a Premature Infant After In Utero Exposure to Rituximab.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Hay%2C+Susanne%22">Hay, Susanne</searchLink><br /><searchLink fieldCode="AR" term="%22Burchett%2C+Sandra%22">Burchett, Sandra</searchLink><br /><searchLink fieldCode="AR" term="%22Odejide%2C+Oreofe%22">Odejide, Oreofe</searchLink><br /><searchLink fieldCode="AR" term="%22Cataltepe%2C+Sule%22">Cataltepe, Sule</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Sep2017, Vol. 140 Issue 3, pe1-e5. 5p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Differential+diagnosis%22">Differential diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Cord+blood%22">Cord blood</searchLink><br /><searchLink fieldCode="DE" term="%22Premature+infants%22">Premature infants</searchLink><br /><searchLink fieldCode="DE" term="%22Rituximab%22">Rituximab</searchLink><br /><searchLink fieldCode="DE" term="%22Sepsis%22">Sepsis</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Rituximab is an increasingly used immunotherapeutic agent for women of reproductive age for treatment of autoimmune diseases, leukemias, and lymphomas. Rituximab is a chimeric monoclonal antibody that targets B-cell surface antigen CD20 and can cross the placenta. Current evidence of the impact of this medication on the developing fetus is limited, but there is little to suggest that fetal exposure to this medication places an infant at increased risk of immunosuppression and subsequent infection. Here we report a case of in utero rituximab exposure that was associated with 2 severe septic episodes with Enterococcus faecalis, in a premature infant of 29 weeks' gestational age with a birth weight of 820 g. The patient had a critically depressed B-lymphocyte subset of 10% and undetectable immunoglobulin (Ig)G, IgM, and IgA levels at 37 weeks' postmenstrual age. Interestingly, both episodes of sepsis coincided with transition from donor human milk to formula feeds. She was treated with intravenous immunoglobulin, antibiotics, and donor human milk. We postulate that placental transfer of rituximab, prematurity, and the low levels of protective maternal antibodies increased the susceptibility of this patient to sepsis by E faecalis, a resident of the normal gut flora, whereas the secretory IgA in donor human milk may have played a protective role. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=125093997
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1542/peds.2016-2819
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 5
        StartPage: e1
    Subjects:
      – SubjectFull: Differential diagnosis
        Type: general
      – SubjectFull: Cord blood
        Type: general
      – SubjectFull: Premature infants
        Type: general
      – SubjectFull: Rituximab
        Type: general
      – SubjectFull: Sepsis
        Type: general
      – SubjectFull: Diagnosis
        Type: general
    Titles:
      – TitleFull: Septic Episodes in a Premature Infant After In Utero Exposure to Rituximab.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Hay, Susanne
      – PersonEntity:
          Name:
            NameFull: Burchett, Sandra
      – PersonEntity:
          Name:
            NameFull: Odejide, Oreofe
      – PersonEntity:
          Name:
            NameFull: Cataltepe, Sule
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Text: Sep2017
              Type: published
              Y: 2017
          Identifiers:
            – Type: issn-print
              Value: 00314005
          Numbering:
            – Type: volume
              Value: 140
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Pediatrics
              Type: main
ResultId 1