Case Report


Diagnosis and treatment of Waldenstrom’s macroglobulinemia in a twin pregnancy

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1 Kansas University School of Medicine, Kansas City, Kansas 66160, USA

2 Department of Obstetrics & Gynecology, Kansas University Medical Center, Kansas City, Kansas 66160, USA

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Brian Harrison

Kansas University School of Medicine, Kansas City, Kansas 66160,

USA

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Article ID: 100058Z08BH2020

doi: 10.5348/100058Z08BH2020CR

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How to cite this article

Harrison B, Winchester ML. Diagnosis and treatment of Waldenstrom’s macroglobulinemia in a twin pregnancy. J Case Rep Images Obstet Gynecol 2020;6:100058Z08BH2020.

ABSTRACT


Introduction: Waldenstrom’s macroglobulinemia (WM) is a rare neoplastic disease with bone marrow involvement and overproduction of immunoglobulin M (IgM). The clinical manifestations range from asymptomatic disease diagnosed incidentally to severe pancytopenia and hyperviscosity syndrome. This disease is incredibly rare in women of reproductive age, let alone pregnancy.

Case Report: The patient presented here was diagnosed with WM during her first trimester. Due to disease severity, she required both plasmapheresis and rituximab. She delivered healthy twin infants vaginally at 34 weeks gestation, after induction of labor for preeclampsia with severe features.

Conclusion: This case highlights the need for a high index of suspicion, and early multidisciplinary involvement to obtain good outcomes for the mother-fetal dyad.

Keywords: Lymphoma, Pregnancy, Waldenstrom’s macroglobulinemia

SUPPORTING INFORMATION


Acknowledgments

We thank our anonymous patient and her desire to contribute to this field for the betterment of others.

Author Contributions

Brian Harrison - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Mae-Lan Winchester - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2020 Brian Harrison et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.