Newly diagnosed adult-onset Still disease in pregnancy

Pan, Vivien L.; Haruyama, Atsuko Z.; Guberman, Cristiane; Kitridou, Rodanthi C.

doi:10.1016/s0029-7844(03)00065-6

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Only limited numbers of studies are published in the forms of case reports or short series of literature reviews. Hence, conclusive interpretations are not available (11)(12)(13)(14). We performed a cohort study to explore the probable interaction between AOSD and pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China

et al. 2020

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Objective: Adult-onset Still's disease (AOSD) is an autoinflammatory disease with a higher prevalence rate in young females. The purpose of this study is to investigate whether AOSD has an adverse impact on pregnancy outcomes, or conversely exacerbated by pregnancy.Methods: The outcomes of 191 pregnancies were evaluated in 86 female patients with AOSD. The generalized linear mixed model and propensity score matching method were conducted to evaluate the influence of AOSD on pregnancy outcomes. A dependent sample sign test was applied to assess the impact of pregnancy on the relapse of AOSD.Results: The results showed that the post-AOSD group had a lower proportion of normal delivery (25.0 vs. 52.4%, p = 0.036) and a higher proportion of spontaneous abortion (STA) (18.8 vs. 0.6%, p = 0.002) compared with the pre-AOSD group. Moreover, pregnancy after being diagnosed with AOSD was a significant high risk factor of STA (adjusted OR = 4.577, 95% CI: 4.166–845.119; p = 0.003). Disease flare upon conception was observed in one of 16 post-AOSD pregnancies (p = 1.000). There were 11 patients with new-onset AOSD during gestation or postpartum, among which five (45.4%) evolved into the polycyclic course.Conclusions: AOSD patients might suffer from a higher risk of STA, however, pregnancy might not be related with the exacerbation of diagnosed AOSD. New-onset AOSD during gestation or postpartum tend to evolve into the polycyclic course.

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Section: Introductionmentioning

confidence: 99%

Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China

et al. 2020

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“…To date, 25 pregnancies that could be analyzed in detail have been reported in 19 patients with AOSD [2][3][4][5][6][7][8][9][10][11][12][13][14][15] (Table 1). Occurrence in pregnancy was identified in 9 patients, and most suffered from the second trimester until puerperium.…”

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confidence: 99%

Adult-onset Still’s disease in pregnancy

et al. 2011

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We report a case of adult-onset Still's disease (AOSD) in a pregnant patient that was successfully treated using intravenous methylprednisolone, cyclosporine, and plasma exchange, allowing safe delivery. Pregnancy appears to be one risk factor for AOSD, and we summarize the relationship between AOSD and pregnancy.A 28-year-old Japanese woman, in the 21st week of her first pregnancy, had suffered from low-grade fever and sore throat for 2 weeks. She was referred to us for a high spiking fever, cervical lymph node enlargement, non-pruritic diffuse rash with typical Köbner's sign, and painful polyarthritis with palpable synovitis affecting the wrists, knees, and ankle joints bilaterally. She was referred to our department and admitted in September 2010. Chest radiography revealed bilateral pleural effusion, which was suggestive of pleuritis. Laboratory studies showed high levels of C-reactive protein (115 mg/L) and ferritin (24,883 ng/mL, normal \120 ng/mL), anemia (hemoglobin 10.5 g/dL), and an elevated white blood cell count (25,100/lL with 96.5% peripheral neutrocytes). Liver dysfunction was identified (aspartate transaminase 123 IU/ L, normal \39 IU/L; alanine aminotransferase 94 IU/L, normal \40 IU/L). Negative results were obtained for serum rheumatoid factor and antinuclear antibody. Blood cultures and exhaustive serological investigation for bacterial and viral etiologies of AOSD-like syndromes repeatedly yielded negative results. Her serum interleukin (IL)-18 level was significantly elevated (128,000 pg/mL), but IL-12 was not detectable. A diagnosis of AOSD was therefore made, according to the criteria described by Yamaguchi et al. [1]. Her symptoms worsened despite the initiation of prednisolone at 60 mg/day (treatment conducted in consultation with the obstetrician). As hemophagocytic syndrome developed as a complication after a few days, she received two courses of intravenous methylprednisolone pulse therapy, and plasma exchange, performed 15 times. Because the short-term effect of the pulse therapy was insufficient, we consulted her obstetrician again, and together with the obstetrician, we judged that maternal survival was the priority. We obtained informed consent for the use of cyclosporine in pregnancy from the patient and her family. Cyclosporine and liposomal dexamethasone palmitate were added after the pulse therapy, leading to improvement in the patient's condition. During the clinical course, the patient suffered from severe oral ulcers induced by cytomegalovirus. Ganciclovir was prescribed because of concerns that congenital cytomegalovirus infection could develop in the fetus. At gestational week 33, she underwent urgent Cesarean section because the fetus showed intrauterine growth restriction, and she gave birth to a 1.3-kg healthy girl with no apparent abnormalities. After 1 month, with no clinical or biological signs of AOSD recurrence, she was discharged with her baby.

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Newly diagnosed adult-onset Still’s disease with pure red cell aplasia in pregnancy

Moussa

Hassan

2014

Arch Gynecol Obstet

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Newly diagnosed adult-onset Still disease in pregnancy

Abstract: Adult-onset Still disease in pregnancy can be confused with many other diseases, but its diagnosis, after exclusion of other infectious, malignant, and rheumatic conditions, can portend good maternal and fetal outcomes.

Cited by 5 publications

References 13 publications

Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China

Pregnancy Outcomes in Patients With Adult-Onset Still's Disease: A Cohort Study From China

Adult-onset Still’s disease in pregnancy

Newly diagnosed adult-onset Still’s disease with pure red cell aplasia in pregnancy

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