# Fetal neonatal alloimmune thrombocytopenia treatment with intravenous immunoglobulin: a challenge in pregnancy management and infection assessment ‒ case report

## TL;DR

This case report discusses the challenges of managing a pregnancy when intravenous immunoglobulin treatment can cause false-positive infection tests.

## Contribution

The paper highlights the risk of misdiagnosing infections due to intravenous immunoglobulin therapy in pregnancy.

## Key findings

- Intravenous immunoglobulin can lead to false-positive anti-treponemal and toxoplasmosis tests.
- Clinicians must be cautious in interpreting serological results during immunoglobulin treatment.
- False positives can cause unnecessary anxiety and treatment for the patient.

## Abstract

Fetal and neonatal alloimmune thrombocytopenia is a rare condition associated with fetal and neonatal morbimortality. Prevention of recurrence includes intravenous immunoglobulin. One challenge in pregnancy surveillance remains the fact that maternal intravenous immunoglobulins therapy can result in false-positive infectious markers. The goal of this case report is to highlight the possible serological misdiagnosed infection associated with intravenous immunoglobulins therapy in pregnancy, and the difficulty of management in this time of a women’s life.

We report a case of a 38-year-old pregnant woman, with a previous affected child with fetal neonatal alloimmune thrombocytopenia. To prevent recurrence, intravenous immunoglobulin treatment was administered in early second trimester. In the second trimester routine analysis, a positive anti-treponemal test and a toxoplasmosis seroconversion occurred. Infection suspicion based on test positivity of some infectious agents, after passive acquired antibodies, can lead to anxiety and subsequent unnecessary treatment.

Clinicians and pathologists must be aware of the possible acquisition of these antibodies during treatment and be able to counsel patients receiving intravenous immunoglobulin. Managing possible infectious intercurrences in pregnancy remains a challenge.