Autoantibodies to protein s and protein S deficiency in patients with recurrent pregnancy loss

Abstract

s for the 29th Annual Congress of Japanese Society / Journal of Reproductive Immunology 106 (2014) 1–20 9 each patient. Among RPL patients, 90 patients (30%) were deficient for total protein S antigen (<65%). Only 8 patients out of these 90 patients were also deficient for protein S activity (<60%). Fifty-seven (27.1%) out of 210 anti-protein S antibody negative patients, 20 (36.4%) out of 55 antiprotein S antibody positive (1+ ormore) patients, 6 (54.5%) out of 11 positive (2+ or more) patients, 4 (100%) out of 4 positive (3+) patients were protein S deficient. There was a significant correlation between total protein S antigen level and autoantibodies to protein S (p=0.0061, OR 24.03). Among 20 protein S deficient patients who were positive (1+ or more) for anti-protein S antibodies and 61 protein S deficient patients who were negative for anti-protein S antibodies, the incidence of each factor was as follows; aPTTmixing test20%vs3.3% (p=0.0304,OR7.38), antiphosphatidylethanolamine antibodies 35% vs 9.8% (p=0.0137, OR 4.94), FXII deficiency 50% vs 23% (p=0.0274, OR 3.36), anti-prothrombin/phoshpatidylserine antibodies 30% vs 18% (NS), anti-FXII antibodies 30% vs 21.3% (NS), anticardiolipin antibodies 5.0% vs 6.6% (NS), respectively. These data indicate a correlation between anti-protein S antibodies and autoantibodies to contact proteins (e.g. FXII and kininogens). Protein Smay play an important role in reproduction. http://dx.doi.org/10.1016/j.jri.2014.09.020 A case report of neonatal hemochromatosis treated by high-dose intravenous immunoglobulin K. Motomura1,4,∗, A. Sasaki1, M. Hisano1, K. Yamaguchi1, Y. Ito1, R. Ito2, M. Kasahara3, K. Matsumoto4, H. Sago1 1 Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Japan 2 Department of Medical Subspecialties, National Center for Child Health and Development, Japan 3 Organ Transplantation Center, National Center for Child Health and Development, Japan 4 Department of Allergy and Immunology, National Research Institute for Child Heath and Development, Japan Neonatal hemochromatosis (NH) is characterized by serious fetal or neonatal liver failure due to alloimmune liver damage. Specific diagnosis using immunohistochemical staining ofmembrane attack complex (MAC IHC) in the liver and maternal treatment with high-dose intravenous immunoglobulin (IVIG) have recently become the standard management. Here, we report a successful pregnancy in a woman whose index pregnancy was diagnosed as NH and who was treated with IVIG. A 37-year-old, gravida 1 para 0 woman delivered a normal-appearing neonate who died of liver failure only 17h after delivery in spite of having shown no symptoms during gestation or delivery. The neonate was diagnosed as NH based on positive MAC IHC staining. After this pregnancy, themother experienced two spontaneousmiscarriages.Duringher latestpregnancy, she received IVIG (1 g/kg/week) after 14 weeks of gestation. She had no complications, and delivered a healthy neonate at term. The neonate showed slight abnormalities in liver function and iron metabolism, which normalized without any treatment. In conclusion, MAC IHCwas useful for diagnosis, and IVIG markedly improved the outcome of the neonate. http://dx.doi.org/10.1016/j.jri.2014.09.021 Subcellular localization of era and their effects on cell size Z.-L. Li ∗, Y. Otsuki Department of Anatomy & Biology, Osaka Medical College,