The First Report of a Pregnancy in a Patient with Purine Nucleoside Phosphorylase Deficiency.

BACKGROUND

The cause of primary immunodeficiency has expanded to nearly 200 distinct disorders. An improved understanding of these disorders has resulted in decreased morbidity and mortality with reciprocal improved life expectancy. Obstetricians should have knowledge of primary immunodeficiency, as more women with these disorders will reach reproductive age.

CASE: 21-year-old G1P0 with purine nucleoside phosphorylase (PNP) deficiency delivered a viable infant vaginally at 37 weeks. Although the patient's diagnosis and pregnancy placed her at increased risk for infection, she remained asymptomatic and infection-free throughout pregnancy.

CONCLUSION

The management of pregnancy complicated by PNP deficiency requires strict immune surveillance and regimented immunoglobulin replacement.