Waldenstrom hypergammaglobulinemic purpura and pregnancy

Abstract

Background: Waldenstrom hypergammaglobulinemic purpura is characterized by hypergammaglobulinemia, recurring purpura, and an elevated erythrocyte sedimentation rate. It is a rare disease and, to our knowledge, there have been no previous reports of its presence during pregnancy. We report a patient with this disease whose pregnancy was complicated by severe fetal growth restriction (FGR) and acute fetal distress. Case: A 24-year-old primigravid woman with a history of Waldenstrom hypergammaglobulinemic purpura and renal insufficiency developed FGF at 32 weeks' gestation. Cesearean delivery was performed at 33.5 weeks because of acute fetal distress, and a 1305-g male infant was delivered. Neonatal outcome was successful. No deterioration of the woman's medical condition occurred during or after her pregnancy. Conclusion: Successful pregnancy outcome is possible in women with Waldenstrom hypergammaglobulinemic purpura. In view of the risk of FGR, close monitoring of fetal growth and well-being is recommended in women with this conditions.