Clinical and laboratory features of ITP and R-ITP lactating patients
| Group and patient . | Mother’s clinical data . | Infant’s clinical data . | Milk-Ig antibodies . | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Antiplatelet*† . | Anti-αIIbβ3*‡ . | |||||||||
| ITP diagnosis . | Treatment during pregnancy . | Platelet count on delivery day . | Platelet count on delivery day (Nadir) . | Treatment . | Approximate lactating period (months)§ . | Stable normal count (months) . | IgA/IgM/IgG . | IgA . | IgA/IgM/IgG . | |
| ITP | ||||||||||
| A.H. | During pregnancy | Corticosteroids and IVGG | 16 000 | 42 000 (22 000)|| | None | 3 | 4.5 | 3/3 | 3/3 | 5/6 |
| A.L. | During pregnancy | Corticosteroids | 56 000 | 29 000 (17 000)|| | Corticosteroids and IVGG | 4 | 4 | 6/6 | 2/3 | 2/3 |
| S.H. | Diagnosed 10 y ago; splenectomized | Corticosteroids | 100 000 | 8000 (4000)|| | Corticosteroids and IVGG | 2.5 | 3.5 | 0/3 | 3/3 | 2/3 |
| S.I. | 3 y before pregnancy | None | 60 000 | 20 000 (20 000)|| | Corticosteroids and IVGG | 3 | 3.5 | 3/6 | 0/4 | 2/5 |
| R.R. | Diagnosed at age 17 y, splenectomized | Corticosteroids | 79 000 | 62 000 (62 000) | None | >6 | 0.3 | 3/6 | 1/3 | 2/3 |
| R.Be. | During pregnancy | None | 49 000 | 43 000 (15 000)|| | IVGG | 2 | 3.5 | 3/7 | 3/7 | 2/5 |
| R.A.H. | During pregnancy | Steroids and IVGG | 36 000 | 48 000 (15 000)|| | Corticosteroids and IVGG | 8 | 2 | 1/3 | 2/3 | 1/3 |
| R-ITP | ||||||||||
| M.A. | Splenectomy | None | 200 000 | 150 000 | NR | 2 | NR | 3/4 | 0/4 | 2/2 |
| B.K. | Thrombocytopenia in pregnancies | None | 118 000 | 235 000 | NR | 10 | NR | 2/2 | 0/3 | 1/4 |
| R.Bl. | ITP at age 16 y | None | 100 000 | 260 000 | NR | 3 | NR | 2/4 | 0/3 | 0/2 |
| A.G. | ITP at age 16 y | None | 303 000 | 240 000 | NR | 2 | NR | 1/3 | 3/3 | 0/4 |
| L.S. | ITP at age 16 y | None | 177 000 | 124 000 | NR | 2 | NR | 1/3 | 3/3 | 0/4 |
| H.N. | Thrombocytopenia in pregnancies | None | 90 000 | 133 000 | NR | 2 | NR | 1/3 | 0/3 | 0/2 |
| Group and patient . | Mother’s clinical data . | Infant’s clinical data . | Milk-Ig antibodies . | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Antiplatelet*† . | Anti-αIIbβ3*‡ . | |||||||||
| ITP diagnosis . | Treatment during pregnancy . | Platelet count on delivery day . | Platelet count on delivery day (Nadir) . | Treatment . | Approximate lactating period (months)§ . | Stable normal count (months) . | IgA/IgM/IgG . | IgA . | IgA/IgM/IgG . | |
| ITP | ||||||||||
| A.H. | During pregnancy | Corticosteroids and IVGG | 16 000 | 42 000 (22 000)|| | None | 3 | 4.5 | 3/3 | 3/3 | 5/6 |
| A.L. | During pregnancy | Corticosteroids | 56 000 | 29 000 (17 000)|| | Corticosteroids and IVGG | 4 | 4 | 6/6 | 2/3 | 2/3 |
| S.H. | Diagnosed 10 y ago; splenectomized | Corticosteroids | 100 000 | 8000 (4000)|| | Corticosteroids and IVGG | 2.5 | 3.5 | 0/3 | 3/3 | 2/3 |
| S.I. | 3 y before pregnancy | None | 60 000 | 20 000 (20 000)|| | Corticosteroids and IVGG | 3 | 3.5 | 3/6 | 0/4 | 2/5 |
| R.R. | Diagnosed at age 17 y, splenectomized | Corticosteroids | 79 000 | 62 000 (62 000) | None | >6 | 0.3 | 3/6 | 1/3 | 2/3 |
| R.Be. | During pregnancy | None | 49 000 | 43 000 (15 000)|| | IVGG | 2 | 3.5 | 3/7 | 3/7 | 2/5 |
| R.A.H. | During pregnancy | Steroids and IVGG | 36 000 | 48 000 (15 000)|| | Corticosteroids and IVGG | 8 | 2 | 1/3 | 2/3 | 1/3 |
| R-ITP | ||||||||||
| M.A. | Splenectomy | None | 200 000 | 150 000 | NR | 2 | NR | 3/4 | 0/4 | 2/2 |
| B.K. | Thrombocytopenia in pregnancies | None | 118 000 | 235 000 | NR | 10 | NR | 2/2 | 0/3 | 1/4 |
| R.Bl. | ITP at age 16 y | None | 100 000 | 260 000 | NR | 3 | NR | 2/4 | 0/3 | 0/2 |
| A.G. | ITP at age 16 y | None | 303 000 | 240 000 | NR | 2 | NR | 1/3 | 3/3 | 0/4 |
| L.S. | ITP at age 16 y | None | 177 000 | 124 000 | NR | 2 | NR | 1/3 | 3/3 | 0/4 |
| H.N. | Thrombocytopenia in pregnancies | None | 90 000 | 133 000 | NR | 2 | NR | 1/3 | 0/3 | 0/2 |
Milk-Ig, total Ig extract from breast milk; NR, not relevant.
Frequency of positive results: the number of positive assays divided by total experiments preformed with the sample (using different platelet donors)
Washed platelet assay.
αIIbβ 3 cell assay.
Lactating period is according to mothers’ statement. Toward the end of the period, formula was also used in parallel.
Full details of the clinical data and treatment are provided in supplemental Figure 1.