A comprehensive guide for managing the reproductive health of patients with vasculitis

Sims, Catherine; Clowse, Megan E.B.

doi:10.1038/s41584-022-00842-z

Cited by 8 publications

(4 citation statements)

References 110 publications

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“…Behçetʼs disease and IgA vasculitis are also considered as part of this group of rheumatic diseases. These diseases are associated with an increased risk of preeclampsia, placental insufficiency, SGA, FGR, preterm birth and hypertension 57 .…”

Section: Vasculitismentioning

confidence: 99%

Section: Vaskulitidenunclassified

“…B. Granulomatose mit Polyangitis oder mikroskopische Polyangitis), mittelgroße (Polyarteriitis nodosa) und große Gefäße (Takayasu-Arteriitis) betreffen, auch der Morbus Behçet und die IgA Vaskulitis werden zu dieser Gruppe rheumatischer Erkrankungen gezählt. Diese Erkrankungen sind mit erhöhten Präeklampsie-, Plazentainsuffizienz-, SGA-, FGR-, Frühgeburts-und Hypertonierisiken assoziiert[57]. Schwangerschaftskontrollen sowie das peri-und postpartale Management sollten analog einer Hypertension-, Präeklampsie-und Plazentainsuffizienz-gefährdeten Frau erfolgen.Die EULAR hat für gängige antirheumatische medikamentöse Therapien einen systematischen Überblick über die vorhandene Datenlage zu Erfahrungen und Sicherheitsaspekten in Schwangerschaft und Stillzeit inklusive Expertenkonsensus vorgelegt[4].…”

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Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Kuschel,

Schäfer-Graf,

Schmidt

et al. 2024

Geburtshilfe Frauenheilkd

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Purpose These recommendations issued by the AGG (Section Maternal Diseases in Pregnancy) were developed as a rapid orientation on maternal rheumatic diseases for counselling and disease management in pregnancy and breastfeeding. Methods The standard literature, consensus and position papers, guidelines and recommendations by other specialist associations were evaluated by a task force of the Section and summarized in these recommendations following a joint consensus process. Recommendations This paper provides an orientating overview of the physiology, pathophysiology and definitions of rheumatic diseases which is relevant for gynecologists and obstetricians. The recommendations focus on the maternal, fetal and neonatal diagnostic workup in cases with underlying maternal rheumatic disease.

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Section: Vasculitismentioning

confidence: 99%

Section: Vaskulitidenunclassified

unclassified

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Management of Rheumatic Diseases During Pregnancy and Breastfeeding

Kuschel,

Schäfer-Graf,

Schmidt

et al. 2024

Geburtshilfe Frauenheilkd

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“…Adolescents should receive contraceptive advice and counseling and need to have access to reproductive health services [ 83 ]. Because of the risk of thrombosis, female traditional risk factors need to be assessed, the best contraceptive methods discussed and, in patients taking multiple medications, potential interactions should be checked.…”

Section: Treatmentmentioning

confidence: 99%

Treatment Options in Pediatric Behçet’s Disease

2023

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Behçet’s disease is a rare and poorly understood vasculitis affecting blood vessels of all types and sizes. Uveitis and oral and genital ulcers represent the typical clinical triad. Populations along the ancient trading route connecting the Mediterranean basin with the Middle and Far East are most affected. Up to a quarter of the cases has a pediatric onset, typically around puberty. The aim of the treatment is early intervention to control inflammation, with symptom relief and prevention of relapses, damage, and complications. The heterogeneous clinical presentation often requires a multidisciplinary and tailored approach. Ocular, neurological, gastrointestinal, and vascular involvement is associated with a worse prognosis and needs more aggressive treatments. In young patients with expected prolonged disease, treatment should also focus on preventive measures and lifestyle advice. In recent years, the pharmacological armamentarium has grown progressively, although only a limited number of drugs are currently authorized for pediatric use. Most evidence for these drugs still derives from adult studies and experience; these are prescribed as off-label medications and are only available as adult formulations. Corticosteroids frequently represent the mainstay for the management of the initial acute phases, but their potential serious adverse effects limit their use to short periods. Different conventional disease-modifying anti-rheumatic drugs have long been used. Many other biologic drugs targeting different cytokines such as interleukin-1, interleukin-6, and interleukin-17 and treatments with small molecules including the phosphodiesterase 4 and Janus kinase inhibitors are emerging as novel promising therapeutic agents. In recent years, a growing interest has developed around anti-tumor necrosis factor agents that have often proven to be effective in severe cases, especially in those with a gastrointestinal and ocular involvement.

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