Leitura clínica
Comentário
As imunoglobulinas (Ig) são proteínas produzidas pelos linfócitos B como resposta humoral a antígenos estranhos ao próprio organismo. As imunoglobulinas utilizadas na prática clínica são preparações a partir de soro ou plasma humano que contêm anticorpos, principalmente IgG. Seu peso molecular elevadíssimo torna muito improvável a passagem para o leite materno em quantidade clinicamente significativa. A administração de imunoglobulina padrão não altera significativamente os níveis de imunoglobulinas (IgG ou IgM) no colostro ou leite materno. (Palmeira 2009) Não foram observados problemas em lactentes cujas mães são tratadas com imunoglobulina por diversas doenças (Gan 2012, Haas 2007 y 2000, Achiron 2004) , exceto um caso de erupção cutânea que se resolveu espontaneamente. (Bostan 2020) Diversas sociedades médicas e consensos de especialistas consideram seguro o uso desta medicação durante a amamentação. (Hale, LactMed, Flint 2016, Götestam 2016, Briggs 2016, Schaefer 2015, Butler 2014, Houtchens 2013, Østensen 2006) Lista de medicamentos essenciais OMS: compatível com a amamentação. (WHO 2002)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 2
- Иммуноглобулины
- Ig
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 0 | % |
| Peso Molecular | 150.000 | daltons |
| T½ | 500 | horas |
Rastreabilidade
Bibliografia
- LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consultado el 16 de Abril de 2024 Texto completo (enlace a fuente original)
- Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consultado el 10 de Abril de 2024 Texto completo (enlace a fuente original)
- Pluma A, Hamroun S, Rüegg L, Cecchi I, Kramer M, Perez-Garcia LF, Rivero T, Finckh A, Meissner Y, Förger F. Antirheumatic drugs in reproduction, pregnancy, and lactation: a systematic literature review informing the 2024 update of the EULAR recommendations. Ann Rheum Dis. 2025 Sep;84(9):1561-1590. Resumen Texto completo (enlace a fuente original)
- Russell MD, Dey M, Flint J, Davie P, Allen A, Crossley A, Frishman M, Gayed M, Hodson K, Khamashta M, Moore L, Panchal S, Piper M, Reid C, Saxby K, Schreiber K, Senvar N, Tosounidou S, van de Venne M, Warburton L, Williams D, Yee CS, et al. British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 2023 Apr 3;62(4):e48-e88. Resumen Texto completo (enlace a fuente original)
- Bostan E, Gülseren D, Ersoy Evans S, Elçin G, Karaduman A, Atakan N. Efficacious treatment of pemphigus vulgaris by intravenous immunoglobulin during pregnancy and postpartum period. Dermatol Ther. 2020 Jan;33(1):e13187. Resumen
- Bitencourt N, Bermas BL. Pharmacological Approach to Managing Childhood-Onset Systemic Lupus Erythematosus During Conception, Pregnancy and Breastfeeding. Paediatr Drugs. 2018 Dec;20(6):511-521. Resumen
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- Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
- Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
- Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Resumen
- Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: therapeutic considerations. J Neurol. 2013 Resumen
- Gan DC, Welsh B, Webster M. Successful treatment of a severe persistent case of pemphigoid gestationis with antepartum and postpartum intravenous immunoglobulin followed by azathioprine. Australas J Dermatol. 2012 Feb;53(1):66-9. Resumen
- Palmeira P, Costa-Carvalho BT, Arslanian C, Pontes GN, Nagao AT, Carneiro-Sampaio MM. Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin. Pediatr Allergy Immunol. 2009 Sep;20(6):528-35. Resumen
- Haas J, Hommes OR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler. 2007 Aug;13(7):900-8. Epub 2007 Mar 15. Resumen
- Østensen M, Khamashta M, Lockshin M, Parke A, Brucato A, Carp H, Doria A, Rai R, Meroni P, Cetin I, Derksen R, Branch W, Motta M, Gordon C, Ruiz-Irastorza G, Spinillo A, Friedman D, Cimaz R, Czeizel A, Piette JC, Cervera R, Levy RA, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Achiron A, Kishner I, Dolev M, Stern Y, Dulitzky M, Schiff E, Achiron R. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol. 2004 Sep;251(9):1133-7. Resumen
- WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Haas J. High dose IVIG in the post partum period for prevention of exacerbations in MS. Mult Scler. 2000 Oct;6 Suppl 2:S18-20; discussion S33. Resumen