Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Nov;128(5):1092-1094.
doi: 10.1097/AOG.0000000000001569.

Gestational Alloimmune Liver Disease: A Devastating Condition Preventable With Maternal Intravenous Immunoglobulin

Hannah B Anastasio  1 , Maureen Grundy, Meredith L Birsner, Karin J Blakemore
Affiliations
Case Reports

Gestational Alloimmune Liver Disease: A Devastating Condition Preventable With Maternal Intravenous Immunoglobulin

Hannah B Anastasio et al. Obstet Gynecol. 2016 Nov.

Abstract

Background: Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise has a recurrence risk above 90% in subsequent pregnancies.

Case: A 30-year-old woman, gravida 3 para 0120, presented early in gestation. Her previous pregnancy had been complicated by fetal growth restriction, oligohydramnios, and ultimately fatal fulminant neonatal liver failure. With gestational alloimmune liver disease recognized as the primary diagnosis for the liver failure, we began maternal weekly IVIG therapy. She delivered a healthy newborn at term without evidence of hepatic dysfunction.

Conclusion: Recognition of gestational alloimmune liver disease enables antepartum treatment that dramatically alters the course of disease.

PubMed Disclaimer

References

    1. Whitington PF, Malladi P. Neonatal hemochromatosis: is it an alloimmune disease? J Pediatr Gastroenterol Nutr 2005;40:544–9.
    1. Whitington PF. Gestational alloimmune liver disease and neonatal hemochromatosis. Semin Liver Dis 2012;32:325–32.
    1. Whitington PF, Hibbard JU. High-dose immunoglobulin during pregnancy for recurrent neonatal hemochromatosis. Lancet 2004;364:1960–8.
    1. Melin-Aldana H, Park C, Pan X, Fritsch M, Malladi P, Whitington P. Gestational autoimmune disease in newborns with indeterminate cause of death following a complete autopsy. J Neonatal Perinatal Med 2015 Mar 12 [Epub ahead of print].
    1. Feldman AG, Whitington PF. Neonatal hemochromatosis. J Clin Exp Hepatol 2013;3:313–20.

Publication types

Substances

Supplementary concepts