Prediction of postpartum onset of rheumatoid arthritis

Abstract

Objective-To investigate the prediction of the postpartum onset of rheumatoid arthritis (RA). Methods-Two thousand five hundred and forty seven healthy pregnant subjects were examined prospectively and the relation between serum rheumatoid factors (RF) and postpartum onset of RA was observed. Rheumatoid factors were measured in early pregnancy by the antihuman IgG latex agglutination test (Latex test) and antirabbit IgG haemagglutination test (RAHA test).Results-Latex test and RAHA test were positive in 26 (1.0%) and 64 (2.5%) pregnant subjects, respectively. Four hundred and ten subjects of 2547 pregnant women could be followed up for one year after delivery. None of 401 subjects without RF, or with only one RF on either Latex test or RAHA test, developed RA after delivery. Two (22.2%) of nine subjects with both RFs developed RA at one and three months postpartum, respectively. Transient arthralgia was found within 12 months postpartum in three of nine (33.3%) subjects with both RFs and this prevalence was significantly higher than that in RF negative subjects (8.1%). Conclusion-Postpartum onset of RA was found in at least 2 of 2547 healthy subjects (0.08%) and onset was predicted by positive test for rheumatoid factors.

Case of Primary Biliary Cirrhosis-Autoimmune Hepatitis Overlap which Manifested after Delivery

“…B cells decrease at 1 month postpartum, but increase at 7-10 months postpartum. The postpartum increases in T and B cells are related to the postpartum onset or aggravation of autoimmune disease (1,(3)(4)(5)(6)(7)(8).…”

“…Onset of some diseases, including AIH and PBC, has been reported after parturition (3)(4)(5)(6)(7)(8)(9). PBC-AIH overlap is comparatively rare.…”

Rheumatoid Arthritis and Pregnancy

“…В течение 6 мес после родов у этих женщин тяжелый РА развивается в 3-5 раз чаще, чем у не кормящих грудью матерей с РА [16][17][18]. С другой стороны, имеются данные [19][20][21], сви-детельствующие в пользу того, что наличие беременно-стей, ранних родов в анамнезе и более позднее менархе уменьшают риск развития РА.…”

Are we at a stage to predict autoimmune rheumatic diseases?

“…The implementation of an aggressive therapy at the onset of the disease has been proven to be particularly successful in limiting or reducing the progression of the erosive lesions and in improving the patient's quality of life (22). The predictive value of RF has been proven in numerous studies (23)(24)(25)(26).…”