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

Excerpt

Hypergammaglobulinemic purpura of Waldenstrom (HGP) is a rare skin condition first described by Waldenstrom in 1943. It presents as recurring purpura, elevated erythrocyte sedimentation rate, mild anemia, hypergammaglobulinemia and the presence of circulating immune complexes. It can be primary or secondary when associated with other autoimmune diseases, especially Sjogren’s and lupus erythematosus. It usually affects females of reproductive-age group, i.e., between 18 to 40 years of age. It is usually a benign condition which does not require extensive investigation and treatment in its primary form. Limited literature is available of its occurrence in pregnancy in which case HGPW requires prompt diagnosis and treatment for better fetal and maternal outcome. The presence of anti-Ro antibodies in the maternal serum may lead to congenital heart block in 1–2% of pregnancies, neonatal lupus rash in around 10–20% of cases with nine times risk of recurrence. Circulating immunoglobulins may lead to IUGR, preeclampsia, anemia or even IUD. Successful fetal and maternal outcome is possible in current and subsequent pregnancies if HGPW is diagnosed and managed on time [1, 2]. …