Chronic histiocytic intervillositis of unknown etiology: Clinical features in a consecutive series of 69 cases

Antiphospholipid syndrome and other autoimmune diseases associated with chronic intervillositis

“…Herein, the screening of autoimmune disease enabled the diagnosis of associated underlying autoimmune disorders in almost 60 % of cases, including patients without specific clinical features. With regard to obstetrical event pregnancies with CIUE, our results were similar to that reported in previous studies, and highlight the severity of this disease (Table 3) [2,4,5,[7][8][9][10]. Interventional therapy to prevent recurrence has included the use of aspirin and corticosteroids [4,[7][8][9].…”

“…In addition, not all placentas can be analyzed, notably placentas in patients with early abortion that may have included CIUE [15]. However, 4,292 placental analyses were performed for AOO in the same period of time in our university hospital; all histological examinations were performed in the same laboratory, as were the immunological screening, and the prevalence of CIUE was 0.4 %, similar to the largest published series [5]. Finally, the presence of specific immunosuppressant treatment in only two patients in the subset of patients does not allow us to assess the benefits of this type of treatment in the patients with CIUE and autoimmune disorders.…”

“…Limitations of the present study, like those of other similar studies [1,2,[4][5][6][7][8]10] include the small number of patients as well as its retrospective design with the possibility of recruitment bias as placental analyses are requested because of the AOO. In addition, not all placentas can be analyzed, notably placentas in patients with early abortion that may have included CIUE [15].…”

“…Primary obstetrical APS was diagnosed in 4 patients according to Sapporo criteria [5,6]. AOO as well as treatments and number of live-born babies in these APS patients are listed in Table 2.…”

“…The presence of increased numbers of maternally derived mononuclear cells in the intervillous space has led to the hypothesis that an immune mechanism may be involved in the pathogenesis of placental lesions [2], and the presence of autoimmune diseases (AID) has been noted in patients with CIUE [2,5]. However, the extent and the benefit of systematic screening of AID in these patients are not currently determined and the presence of underlying AID could raise the relevance of immunosuppressant treatment.…”