{"created":"2023-06-20T15:48:59.597032+00:00","id":3516,"links":{},"metadata":{"_buckets":{"deposit":"b0af4ba5-c0fa-483e-ba58-ec8552eaa6cf"},"_deposit":{"created_by":4,"id":"3516","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3516"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003516","sets":["1:12:72"]},"author_link":["10330","10331","10332","10333","10334","10335","10336","10337","10338","10339","10340"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-09","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"150","bibliographicPageStart":"144","bibliographicVolumeNumber":"8","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"選択的IgA欠損症は、IgAのみが欠損した、免疫不全症の一種である。約30％がSLE、ITPなどの自己免疫疾患を罹患し、自己免疫疾患の精査中に診断されることもある。本疾患の約40％が抗IgA抗体を保有しているため、血液製剤の投与により、アナフィラキシー反応が惹起される可能性があり、注意が必要である。今回我々は、妊娠初期に認められた血小板減少症の精査中に選択的IgA欠損症と診断された1例を経験したので報告する。症例は、35歳、2妊0産、IVF-ETで妊娠成立後、初期検査にて血小板数が7.7×104/μlであったため、精査目的に当科を紹介受診した。抗核抗体やPAIgGなどの自己抗体を認めたが、明らかな自己免疫疾患の診断には至らなかった。精査の過程で選択的IgA欠損症と診断された。抗IgA抗体は陽性であった。妊娠41週0日に胎児機能不全の診断で緊急帝王切開となった。術中、自己血新鮮凍結血漿と洗浄置換血小板を輸血した。自己抗体を検索する必要のある妊婦に対しては、IgA欠損症の有無に注意する必要があると考えられた。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Selective IgA deficiency (SIgAD) is an immunodeficiency disorder defined as an undetectable level of serum IgA level in the serum immunoglobulin isotypes. Autoimmune diseases such as systemic lupus erythematosus and idiopathic thrombocytopenic purpura are associated with about 30% of all SIgAD cases, which makes incidental detection of SIgAD possible during scrutiny for autoimmune diseases. Approximately 40% of SIgAD patients carry anti-IgA antibodies, and this creates a risk of anaphylaxis by administration of blood products, therefore caution is needed for transfusion procedures. We herein report a case of SIgAD which was diagnosed with thrombocytopenia during the first trimester of pregnancy. A 35-year-old gravid 2 para 0 female got pregnant by in vitro fertilization-embryo transfer. Since the number of platelets were 5×10⁴/μl during blood screening, she was referred to our department for examination of thrombocytopenia. Serum anti-nuclear antibody and some autoantibodies such as PAIgG were positive, but it did not lead to the diagnosis of an autoimmune disease. During the course of examinations, she was diagnosed with SIgAD. Serum anti-IgA antibody was positive, and an emergency caesarean section was performed for non-reassuring fetal status at 41 weeks and 0 day of gestation. During the operation, fresh frozen plasma derived from autologous blood and washed/replaced platelet concentrate were transfused. For pregnant women who need to search for autoantibodies, it was considered necessary to pay attention to the presence of SIgAD.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"飯田, 瀬里香","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"矢田, 大輔","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"幸村, 友季子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"井上, 結貴","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松本, 智恵子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福地, 千恵","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"磯村, 直美","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"内田, 季之","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, 一有","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊東, 宏晃","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金山, 尚裕","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-09-24"}],"displaytype":"detail","filename":"jsog_8_2_144.pdf","filesize":[{"value":"613.5 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_8_2_144","url":"https://hama-med.repo.nii.ac.jp/record/3516/files/jsog_8_2_144.pdf"},"version_id":"42d5e960-25bc-4457-aea5-97c8e441307b"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"selective IgA deficiency","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"thrombocytopenia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"autoantibodies","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"blood product","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"妊娠初期に認められた血小板減少症の精査中に選択的IgA欠損症と診断された1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"妊娠初期に認められた血小板減少症の精査中に選択的IgA欠損症と診断された1例","subitem_title_language":"ja"},{"subitem_title":"A case of selective IgA deficiency which was diagnosed with thrombocytopenia during the first trimester of pregnancy","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["72"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2019-09-24"},"publish_date":"2019-09-24","publish_status":"0","recid":"3516","relation_version_is_last":true,"title":["妊娠初期に認められた血小板減少症の精査中に選択的IgA欠損症と診断された1例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:56:52.860606+00:00"}