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Lymphocyte changes and vaccination response in a child exposed to belimumab during pregnancy
  1. Helle Bitter1,
  2. Anne Noraas Bendvold2,
  3. Monika Elisabeth Østensen1
  1. 1Department of Rheumatology, Sørlandet Hospital, Kristiansand, Norway
  2. 2Rheumatology Specialists of Kristiansand, Kristiansand, Norway
  1. Correspondence to Professor Monika Elisabeth Østensen, Department of Rheumatology, Sørlandet Hospital, Kristiansand 4615, Norway; monika.ostensen{at}gmail.com

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Apart from animal studies,1 no human studies exist to document the transfer of belimumab (BEL) to the fetus and immunological alterations caused in the neonate.2 We report the case of a mother treated with BEL for systemic lupus erythematosus (SLE) both before and during pregnancy and present the immunological changes observed in the child at birth and during 7 months of follow-up.

Case report

A 29-year-old woman with SLE from 2005 with arthritis and lupus skin disease. During her first pregnancy in 2005–2006, she had a severe flare of lupus with pericarditis and glomerulonephritis, hypertension and premature delivery at week 33. She recovered under therapy with prednisone, azathioprine (AZA; started after a normal thiopurine S-methyltransferase (TPMT) gen test) and hydroxychloroquine (HCQ), and experienced no relapse of lupus nephritis under continued triple therapy.

In 2013, she developed severe lupus skin disease …

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