Colitis therapy tied to 4 cases of low white blood cell count in newborns, but some docs question the finding
WebMD News from HealthDay
By Alan Mozes
HealthDay Reporter
FRIDAY, Oct. 3, 2014 (HealthDay News) -- When given to pregnant women, a common treatment for ulcerative colitis may inadvertently lower their baby's ability to fight off infections at birth, new French research suggests.
The treatment, called anti-TNF therapy, is an injected, artificial antibody. This type of medication is widely seen as a safe and effective way to tackle a wide range of autoimmune disorders, such as rheumatoid arthritis and inflammatory bowel conditions that include ulcerative colitis and Crohn's disease. It's not unusual for pregnant women to receive the treatment, given that inflammatory bowel diseases often strike women of childbearing age.
However, this type of drug can cross the placenta and reach the fetus, the study authors said. And four French cases -- all involving babies born to women exposed to Remicade (infliximab) during pregnancy -- suggest the therapy may cause newborn neutropenia, which is an abnormally low white blood cell count.
The result: severe skin lesions and blistering due to the baby's inability to produce enough neutrophils, a key type of white blood cell needed to fight off bacterial and fungal infections.
But two U.S. experts questioned the study findings. They said the drugs are considered safe and effective -- and potential harms if the drugs aren't taken during pregnancy can include miscarriage or premature delivery.
Dr. Loic de Pontual, of the Service de Pediatrie at the Hopital Jean Verdier in Bondy, France, and colleagues reported their findings in the October issue of the journal Pediatrics.
According to the Crohn's & Colitis Foundation of America, ulcerative colitis may affect as many as 700,000 Americans. It develops when a person's immune system goes out of whack, erroneously interpreting the normal digestive process (such as incoming food) as an attack on the large intestine.
For many patients, this leads to significant abdominal discomfort and cramping alongside persistent diarrhea, all stemming from severe inflammation of the intestinal lining. For many, anti-TNF treatment is the answer.
"TNF is a chemical of inflammation that is overproduced in ulcerative colitis and a number of other inflammatory disorders," said Dr. Stephen Hanauer, director of the digestive health center at Northwestern University's Feinberg School of Medicine, in Chicago. "So, infliximab is an anti-TNF drug that neutralizes it. And I would say it's highly effective and, in general, very safe."
Dr. Jonathan Ramprasad, a pediatric gastroenterologist with McLane Children's Scott & White Hospital in Temple, Texas, agreed.
"The treatment is common, safe and state-of-the-art," he said. "It's a very specific biologic intervention that is widely used for many conditions."
Neither doctor participated in the French study cases, all four of which involved the onset of either moderate or severe neutropenia within the first few days or weeks of life.
source : Certain Autoimmune Drugs in Pregnancy May Up Newborn Infection Risk: Study
