Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report

Nujud Daham,1 Abdullah AlMuqrin,2 Abdulaziz Madani,3 Fahad AlSaif3 1Department of Dermatology, Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia; 2Department of Dermatology, Prince Mohammed Bin Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Dermatology, College of Medicine, Kin...

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Autores principales:	Daham N, AlMuqrin A, Madani A, AlSaif F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	adalimumab exencephaly neural tube defects pregnancy psoriasis tnf-α Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/95e4cba04caa4548be183db2ef43575d
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spelling	oai:doaj.org-article:95e4cba04caa4548be183db2ef43575d2021-12-02T12:13:47ZFetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report1177-5491https://doaj.org/article/95e4cba04caa4548be183db2ef43575d2020-11-01T00:00:00Zhttps://www.dovepress.com/fetal-acrania-exencephaly-in-the-context-of-a-pregnant-female-taking-a-peer-reviewed-article-BTThttps://doaj.org/toc/1177-5491Nujud Daham,1 Abdullah AlMuqrin,2 Abdulaziz Madani,3 Fahad AlSaif3 1Department of Dermatology, Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia; 2Department of Dermatology, Prince Mohammed Bin Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Nujud DahamDepartment of Dermatology, Dr. Sulaiman Al-Habib Medical Group, King Fahad Road, Olaya, Po Box 91877, Riyadh 11643, Saudi ArabiaTel +966 500211134Email nujud.daham@gmail.comAbstract: Adalimumab is a fully human, recombinant, IgG1 monoclonal antibody that targets tumor necrosis factor-alpha (TNF-alpha). It has been established that adalimumab can cross the placenta and can be detected in the fetal circulation for up to 6 months postpartum. However, clinical studies have failed to show any consistent or specific adverse fetal outcomes from maternal exposure to adalimumab during pregnancy. In our report, we present a case of fetal acrania (exencephaly) in the setting of a pregnant female taking adalimumab prior to and during pregnancy. Exencephaly is a neural tube defect (NTD) that results from failure of closure of the neural fold. It is true that there were other risk factors that might have contributed to our patient’s unfortunate outcome. For example, she did not take folic acid supplementation prior to or during her pregnancy. Nonetheless, studies have shown that folic acid deficiency alone is not sufficient to lead to the development of NTDs. Our patient’s exposure to adalimumab during her pregnancy might have added to the risk in her situation. Our report aims to inform clinicians of that possible risk and to stimulate them to report any similar outcomes.Keywords: adalimumab, exencephaly, neural tube defects, pregnancy, psoriasis, TNF-αDaham NAlMuqrin AMadani AAlSaif FDove Medical Pressarticleadalimumabexencephalyneural tube defectspregnancypsoriasistnf-αMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol Volume 14, Pp 127-129 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	adalimumab exencephaly neural tube defects pregnancy psoriasis tnf-α Medicine (General) R5-920
spellingShingle	adalimumab exencephaly neural tube defects pregnancy psoriasis tnf-α Medicine (General) R5-920 Daham N AlMuqrin A Madani A AlSaif F Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
description	Nujud Daham,1 Abdullah AlMuqrin,2 Abdulaziz Madani,3 Fahad AlSaif3 1Department of Dermatology, Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia; 2Department of Dermatology, Prince Mohammed Bin Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Nujud DahamDepartment of Dermatology, Dr. Sulaiman Al-Habib Medical Group, King Fahad Road, Olaya, Po Box 91877, Riyadh 11643, Saudi ArabiaTel +966 500211134Email nujud.daham@gmail.comAbstract: Adalimumab is a fully human, recombinant, IgG1 monoclonal antibody that targets tumor necrosis factor-alpha (TNF-alpha). It has been established that adalimumab can cross the placenta and can be detected in the fetal circulation for up to 6 months postpartum. However, clinical studies have failed to show any consistent or specific adverse fetal outcomes from maternal exposure to adalimumab during pregnancy. In our report, we present a case of fetal acrania (exencephaly) in the setting of a pregnant female taking adalimumab prior to and during pregnancy. Exencephaly is a neural tube defect (NTD) that results from failure of closure of the neural fold. It is true that there were other risk factors that might have contributed to our patient’s unfortunate outcome. For example, she did not take folic acid supplementation prior to or during her pregnancy. Nonetheless, studies have shown that folic acid deficiency alone is not sufficient to lead to the development of NTDs. Our patient’s exposure to adalimumab during her pregnancy might have added to the risk in her situation. Our report aims to inform clinicians of that possible risk and to stimulate them to report any similar outcomes.Keywords: adalimumab, exencephaly, neural tube defects, pregnancy, psoriasis, TNF-α
format	article
author	Daham N AlMuqrin A Madani A AlSaif F
author_facet	Daham N AlMuqrin A Madani A AlSaif F
author_sort	Daham N
title	Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
title_short	Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
title_full	Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
title_fullStr	Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
title_full_unstemmed	Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report
title_sort	fetal acrania (exencephaly) in the context of a pregnant female taking adalimumab for psoriasis: a case report
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/95e4cba04caa4548be183db2ef43575d
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Fetal Acrania (Exencephaly) in the Context of a Pregnant Female Taking Adalimumab for Psoriasis: A Case Report

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