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Lymphocyte changes and vaccination response in a child exposed to belimumab during pregnancy
  1. Helle Bitter1,
  2. Anne Noraas Bendvold2,
  3. Monika Elisabeth Østensen1
  1. 1 Department of Rheumatology, Sørlandet Hospital, Kristiansand, Norway
  2. 2 Rheumatology Specialists of Kristiansand, Kristiansand, Norway
  1. Correspondence to Professor Monika Elisabeth Østensen, Department of Rheumatology, Sørlandet Hospital, Kristiansand 4615, Norway; monika.ostensen{at}gmail.com

https://doi.org/10.1136/annrheumdis-2018-213004

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    Apart from animal studies,1 no human studies exist to document the transfer of belimumab (BEL) to the fetus and immunological alterations caused in the neonate.2 We report the case of a mother treated with BEL for systemic lupus erythematosus (SLE) both before and during pregnancy and present the immunological changes observed in the child at birth and during 7 months of follow-up.

    Case report

    A 29-year-old woman with SLE from 2005 with arthritis and lupus skin disease. During her first pregnancy in 2005–2006, she had a severe flare of lupus with pericarditis and glomerulonephritis, hypertension and premature delivery at week 33. She recovered under therapy with prednisone, azathioprine (AZA; started after a normal thiopurine S-methyltransferase (TPMT) gen test) and hydroxychloroquine (HCQ), and experienced no relapse of lupus nephritis under continued triple therapy.

    In 2013, she developed severe lupus skin disease …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors HB and ANB performed the clinical follow-up of the patient and her child. All authors were involved in the decision-making and the management during pregnancy and after delivery and have read and approved the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.