Neonatal Lupus and IUGR Following Alpha-Interferon Therapy during Pregnancy

Abstract

Interferon alfa-2a is a cytokine produced by recombinant DNA techniques and has antiproliferative, antiviral and immunomodulating effects. A number of case reports in the past have suggested relative safety of alpha-interferons during pregnancy with little or no effect on the fetus. A 15-year-old adolescent became pregnant while receiving alpha-interferon for essential thrombocythemia. She delivered a small-for-gestational age baby girl at 33 weeks gestation. The infant displayed a facial rash characteristic of neonatal lupus and transient thrombocytopenia; maternal and neonatal serologies were typical for drug-induced lupus. These findings suggest probable association between maternal use of alpha interferon and adverse effects in the fetus.

Treatment considerations in patients with concomitant viral infection and autoimmune rheumatic diseases

“…The disease can present from 2 weeks to 7 years after IFNa therapy, but it usually resolves after cessation of IFNa treatment [87]. Neonatal lupus following maternal treatment with IFNa has also been reported [88]. IFNa-induced RA or polyarthritis is rare.…”

Interferon-α for Treatment of Essential Thrombocythemia during Pregnancy: Case Report and Review of the Literature

“…Commonly found obstetrical complications in this high risk population were reported: 5 intra-uterine growth retardations, 1 preeclampsia, 1 thrombophlebitis and 4 hemorrhagic complications ( table 1 ). The only possible significant neonatal adverse effect reported was neonatal facial rash and transient thrombocytopenia [4] , which questions safety of obstetrical maneuvers and instrumental extraction in this situation. Nevertheless, to our knowledge, there has been no pediatric data with long-term follow-up on the safety of INF-␣ during pregnancy reported in the literature.…”

Patients with essential thrombocytosis during pregnancy: Challenges and therapeutic dilemmas

“…Severe adverse events were not reported; nevertheless there is a reported case of an infant with neonatal lupus and thrombocytopenia in a patient that was exposed to IFNa during pregnancy [52].…”