Antiphospholipid antibodies and recurrent abortion

Article Abstract:

Anticardiolipin antibodies and lupus anticoagulants (also called antiphospholipid antibodies) are made by cells of the immune system (the body's natural defense system for fighting infection). They can appear in the blood of patients with autoimmune diseases, such as systemic lupus erythematosus (a connective tissue disease), where the immune system attacks and destroys the body's own tissues. Also, they can appear in patients with blood vessel diseases that cause blood clots to form (thrombosis) or they can occur in the absence of disease. The presence of these antibodies in the blood of pregnant women has been reported to increase the risk of spontaneous abortion (miscarriage). In a recent study, anticardiolipin antibodies were found in the blood of 42 out of 99 Swedish women who had three or more spontaneous abortions. However, in a study conducted in the United States, only 8 of 61 women who experienced two or more spontaneous abortions had high levels of anticardiolipin antibodies in their blood. To investigate this issue further, blood levels of these antibodies were measured in 220 women who had two or more spontaneous abortions, and in 193 women with no history of spontaneous abortion. Seven percent of the women who experienced spontaneous abortion had lupus anticoagulants in their blood, and 19 percent had high levels of anticardiolipin antibodies. Lupus anticoagulants were not found in the blood of the women who did not have spontaneous abortions, and only 3 percent of these women had high levels of anticardiolipin antibodies in their blood. Based on these results, it is concluded that the risk of recurrent abortion is increased 10-fold in women with high blood levels of anticardiolipin antibody, and is several times greater in women who have lupus anticoagulants in their blood. However, the exact role that these antibodies play in spontaneous abortion is not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Risk factors, Immunoglobulins, Miscarriage, Antiphospholipid antibodies

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Recurrent anaphylaxis to a depot form of GnRH analogue

Article Abstract:

Anaphylaxis, also called immediate hypersensitivity, is a severe form of allergic reaction. It can occur following exposure to dust, animal fur, medications or any other substance that causes an allergic reaction. When anaphylaxis occurs, cells in the immune system release chemicals, such as histamine, that cause the air passages in the lungs to constrict or become narrow. This makes breathing very difficult, and in severe cases it can result in shock and death. Drug treatment with hormone preparations does not usually cause anaphylaxis, but a case was seen in which a woman developed anaphylaxis while being treated with gonadotropin releasing hormone (GnRH) for endometriosis (the abnormal growth of endometrial tissue outside of the uterus). The GnRH (Lupron) was being administered as a depot or repository (one injection of a preparation that releases small amounts of drug over long periods of time). Six hours after GnRH was administered, the patient developed hives and had difficulty breathing. She was treated with epinephrine and diphenhydramine for her symptoms. Ten days later the patient had another episode of hives and shortness of breath, and was treated with the same medications. Four days later, the patient was hospitalized because of two additional episodes. While in the hospital the patient had six more attacks of hives and shortness of breath. An allergy skin test to GnRH was performed and it was found that the patient was allergic to GnRH. Fourteen weeks after the injection of GnRH, no GnRH was detectable in the patient's blood. However, the patient continued to have daily episodes of hives that were treated with terfenadine and bee-sting kits. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Development and progression, Allergy, Gonadotropin releasing hormone, Gonadorelin, Anaphylaxis

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