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Case Reports in Hematology
Volume 2017, Article ID 7289126, 3 pages
https://doi.org/10.1155/2017/7289126
Case Report

Paroxysmal Nocturnal Hemoglobinuria in Pregnancy: A Dilemma in Treatment and Thromboprophylaxis

1Department of Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, FL, USA
2Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA
3Department of Pharmacology, University of Florida, Gainesville, FL, USA

Correspondence should be addressed to Arpan Patel; ude.lfu.enicidem@letap.napra

Received 13 July 2017; Accepted 23 August 2017; Published 24 September 2017

Academic Editor: Kostas Konstantopoulos

Copyright © 2017 Arpan Patel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity. We present a case of a patient who was safely on both eculizumab and modest prophylactic anticoagulation for 6 weeks post-partum.