Hypergammaglobulinemic Purpura of Waldenstrom (HGPW) in Pregnancy: A Rare Case Report

摘要

Hypergammaglobulinemic purpura of Waldenstrom (HGP)is a rare skin condition first described by Waldenstrom in1943. It presents as recurring purpura, elevated erythrocytesedimentation rate, mild anemia, hypergammaglobulinemiaand the presence of circulating immune complexes. Itcan be primary or secondary when associated with otherautoimmune diseases, especially Sjogren’s and lupus erythematosus.It usually affects females of reproductive-agegroup, i.e., between 18 to 40 years of age. It is usually abenign condition which does not require extensive investigationand treatment in its primary form. Limited literatureis available of its occurrence in pregnancy in whichcase HGPW requires prompt diagnosis and treatment forbetter fetal and maternal outcome. The presence of anti-Roantibodies in the maternal serum may lead to congenital heart block in 1–2% of pregnancies, neonatal lupus rash inaround 10–20% of cases with nine times risk of recurrence.Circulating immunoglobulins may lead to IUGR,preeclampsia, anemia or even IUD. Successful fetal andmaternal outcome is possible in current and subsequentpregnancies if HGPW is diagnosed and managed on time.