Die aktuellen Warnhinweise zu Missbildungen bei Kindern, deren Mütter während der Schwangerschaft Mycofenolatmofetil eingenommen haben, zeigen, wie aufmerksam das Thema immunsuppressive Therapie und Schwangerschaft weiterhin betrachtet werden muss. Wir stellen den Fall einer 32–jährigen Patientin mit Morbus Crohn vor, die unter einer Azathioprintherapie schwanger geworden war. Die Therapie wurde fortgesetzt, der Krankheitsverlauf war stabil, und die Patientin brachte einen gesunden Jungen zur Welt. Dennoch muss unter immunsuppressiver Therapie eine suffiziente Kontrazeption weiterhin vorbehaltlos empfohlen werden. Sollte es trotzdem zu einer Schwangerschaft kommen, kann der behandelnde Arzt jedoch inzwischen in enger Kooperation mit dem Pränatalmediziner häufig eine Interruptio vermeiden.
Present warnings of malformations that may occur in children whose mothers had taken the immunosuppressant mycofenolatmofetil during pregnancy demonstrate the great need to keep a close watch on the possible effects of immunosuppressive therapy during pregnancy. We present the case of a 32–year old female patient suffering from Crohn's disease who became pregnant while undergoing azathioprine therapy. Therapy was continued; the course of the disease remained stable and the patient gave birth to a healthy male. Inspite of this fortunate outcome we must continue to recommend without prejudice satisfactory contraceptive measures if the patient is undergoing immunosuppressive treatment. However, in case pregnancy does occur, the physician may often prevent an interruption of the pregnancy in close co–operation with the prenatal physician.
Key words
Crohn's disease - Crohn's colitis - immunosuppression - azathioprine - pregnancy
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Korrespondenz
Prof. Dr. Henning E. Adamek
Medizinische Klinik 2 Klinikum Leverkusen gGmbH
Am Gesundheitspark 11
51375 Leverkusen
Email: adamek@klinikum-lev.de
