Eculizumab-Related Abortion in a Woman with Paroxysmal Nocturnal Hemoglobinuria: A Case Report

Background: The use of eculizumab during pregnancy has generally been discour-aged. Published data on related studies provides conflicting information and estab-lishing a benefit-risk relationship proves to be a complicated task. Miscarriage rates, concomitant medications, and the stages of pregnancy when eculizumab treatment was initiated varied among the patients included in the case series. The aim of this report is to discuss eculizumab use during pregnancy. Case Presentation: A case of a woman diagnosed with Paroxysmal Nocturnal He-moglobinuria (PNH) and treated with eculizumab, who expressed desire for preg-nancy is presented. Six months after her eculizumab treatment, the patient experi-enced spontaneous abortion in her first trimester. The direct relation between eculi-zumab and the miscarriage is not clear. Other factors may have influenced this case, thus demonstrating the difficulty of managing pregnancy in women with PNH. Conclusion: Controversy on eculizumab risk during pregnancy encourages further review on its use, highlighting the importance to assess each case individually.