Steroid treatment can play an important role in managing fetal and neonatal alloimmune thrombocytopenia (FNAIT), but its benefits come with significant effects on the immune system.
Understanding why steroids are used, as well as what benefits and side effects they may bring, can help you be more informed and prepared when managing an FNAIT diagnosis.
FNAIT and the immune response
FNAIT is a rare immune-mediated condition that occurs when a pregnant woman’s immune system produces antibodies against platelet antigens inherited by the fetus from the other parent. These antibodies cross the placenta and destroy fetal platelets, increasing the risk of serious bleeding, including intracranial hemorrhage.
Because the condition is driven by an overactive immune response, treatment strategies often focus on suppressing that response.
Why steroids are used to treat FNAIT
Steroids such as prednisone are potent immunosuppressive drugs. When used to treat FNAIT, they can help reduce the production and activity of antiplatelet antibodies.
Learn more about FNAIT treatment and care
By calming the immune system, steroids may help limit the number of antibodies reaching the fetus and slow platelet destruction, lowering the risk of severe complications.
How steroids suppress the immune system
Steroids work by broadly dampening immune activity. They reduce the function of key immune cells, including B cells that produce antibodies and T cells that coordinate immune responses.
Steroids also decrease the release of cytokines, the signaling molecules that drive inflammation. This widespread suppression is effective in controlling harmful immune reactions, but it also means your body may not fight infections as effectively while you are taking them.
Infection risk
Because steroids weaken normal immune defenses, people taking them are more vulnerable to infections. Common illnesses may occur more easily or take longer to resolve. Steroids can also mask common signs of infection, such as fever, making illness harder to spot early.
Some patients experience side effects while using steroids, including mood changes, sleep problems, higher blood sugar levels or weight gain, especially with longer-term use.
Weighing Benefits and Risks
When managing FNAIT, steroids are not used lightly. Your care team carefully balances the potential side effects against the very real risk of serious bleeding in the baby, choosing appropriate doses and treatment length to give the most benefit with the least risk.
If you have concerns about steroid treatment, ask your doctor why it has been recommended. Understanding the purpose of treatment can help you feel more confident and supported as you navigate pregnancy with FNAIT.
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