No abstract

AHP is a very rare complication of RVE. Unexplained hypoglycemia and hypotension should prompt evaluation for AHP in RVE. AHP is associated with severe RVE, multi-organ dysfunction, bleeding and need for transfusion. Prompt treatment with steroids may reduce mortality related to AHP in RVE.

Physiological changes during normal pregnancy are likely to give rise to musculoskeletal symptoms. On the other hand, autoimmune rheumatological diseases disproportionately affect women, often presenting during the childbearing years and sometimes during pregnancy. Contrary to autoimmune rheumatological diseases, the management of non-autoimmune musculoskeletal manifestations is generally conservative and often tends to resolve after pregnancy. It is therefore important to be aware of various musculoskeletal problems seen in the course of pregnancy. In this narrative review, commonly encountered non-autoimmune musculoskeletal problems during pregnancy have been described.

BACKGROUND:The usefulness of anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies)

In patients with systemic sclerosis (SSc), antiphospholipid antibodies (aPL) have been reported to be associated with more severe manifestations including digital infarct, gangrene and pulmonary hypertension. But these findings are not consistent in all studies; moreover, there are no data available from Indian subcontinent. The objective of this study is to assess the prevalence of antiphospholipid antibodies in Indian SSc patients and correlate them with clinical and immunological features. Seventy-two patients were recruited prospectively from rheumatology clinic from 2002 to 2006. Their medical records were reviewed. Anticardiolipin antibodies (IgG, IgM) by ELISA and lupus anticoagulant (LA) were tested in standardized pattern and repeated after 6 weeks. Anti-β2 glycoprotein-I antibodies were done in patients who had aPL antibodies. Nineteen patients had diffuse cutaneous SSc and 53 had limited disease. Seven patients (9.7%) were positive for aPL antibodies in their sera. Only one patient had clinical features of antiphospholipid antibody syndrome and manifested with recurrent abortions and deep vein thrombosis. She was positive for aCL, LA and anti-β2 glycoprotein-I antibodies. Four patients were only aCL (IgG) positive in moderate titers and one each had only aCL (IgM) and LAC positivity. None of the clinical parameters showed an association with aPL antibody.