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
. 2021 Mar 23;47(1):69.
doi: 10.1186/s13052-021-01025-4.

Erythropoietin therapy in a case of neonatal anemia after exposure to natalizumab throughout pregnancy

Elisabetta Godano  1 , Fabio Barra  2 , Alessandra Allodi  1 , Antonella Ferraiolo  3 , Alice Laroni  4   5 , Giovanni Novi  5 , Giovanni Luigi Mancardi  5   6 , Claudio Gustavino  3 , Cesare Arioni  1
Affiliations
Case Reports

Erythropoietin therapy in a case of neonatal anemia after exposure to natalizumab throughout pregnancy

Elisabetta Godano et al. Ital J Pediatr. .

Abstract

Background: Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women with highly active disease who plan a pregnancy or have an unplanned pregnancy, after accurate counseling about eventual maternal disease relapse due to therapy suspension.

Case presentation: This brief case report describes a case of documented anemia that we observed in a newborn whose mother with relapsing-remitting multiple sclerosis was treated with an extended dosing protocol of natalizumab throughout pregnancy. The newborn received the infusion of erythropoietin every seven days from the fortieth day of life; subsequently, the status of anemia underwent clinical resolution.

Conclusions: This case report confirmed that natalizumab can cause disorders of hematopoiesis, including anemia, thrombocytopenia, or pancytopenia, in newborns of patients treated during pregnancy. A multidisciplinary team, including experienced pediatricians and pediatric hematologists, has a critical role in managing newborns delivered by women, being treated with natalizumab for treating relapsing-remitting multiple sclerosis during pregnancy.

Keywords: Anemia; Erythropoietin; Multiple sclerosis; Natalizumab; Pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

References

    1. Rudick R, Polman C, Clifford D, Miller D, Steinman L. Natalizumab: bench to bedside and beyond. JAMA Neurol. 2013;70(2):172–182. doi: 10.1001/jamaneurol.2013.598. - DOI - PubMed
    1. Wehner NG, Shopp G, Rocca MS, Clarke J. Effects of natalizumab, an alpha4 integrin inhibitor, on the development of Hartley Guinea pigs. Birth Defects Res B Dev Reprod Toxicol. 2009;86(2):98–107. doi: 10.1002/bdrb.20189. - DOI - PubMed
    1. Duquette P, Prat A. How safe is natalizumab during pregnancy? Mult Scler. 2015;21(2):121–122. doi: 10.1177/1352458514555789. - DOI - PubMed
    1. Schneider H, Miller RK. Receptor-mediated uptake and transport of macromolecules in the human placenta. Int J Dev Biol. 2010;54(2–3):367–375. doi: 10.1387/ijdb.082773hs. - DOI - PubMed
    1. Chaparro M, Gisbert JP. Transplacental transfer of immunosuppressants and biologics used for the treatment of inflammatory bowel disease. Curr Pharm Biotechnol. 2011;12(5):765–773. doi: 10.2174/138920111795470903. - DOI - PubMed

Publication types

LinkOut - more resources