Fulminant Pregnancy-Related Churg-Strauss Syndrome

Connolly, J. O.; Lanham, J; Partridge, Martyn R

doi:10.1093/rheumatology/33.8.776

Cited by 29 publications

(16 citation statements)

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“…В литературе описаны случаи беременности, которые завершились рождением здорового ребенка. Есть данные литературы о том, что 50% женщин забере-менели в период ремиссии болезни [18,22]. Обычно наблюдается недоношенность плода, у большинства таких пациенток роды протекают нормально, но у новорожденных -низкая масса тела.…”

Section: беременность у больных с системными первичными васкулитамиunclassified

Systemic primary vasculitis and pregnancy

Voznesenskaja¹,

Litvinenko²,

Blashkiv³

2015

Probl. reprod.

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Классификация васкулитовТермин «васкулит» обозначает воспаление кро-веносных сосудов. Патологическим следствием та-кого воспаления является разрушение стенки сосу-да, видимое гистологически как фибриноидный не-кроз, отсюда и термин «некротический васкулит». Васкулит может быть локализован в одном органе или сосудистом русле и может быть клинически не-значительным, но чаще всего он генерализируется. Мышечные артерии могут развивать фокальные или сегментные поражения, которые могут представлять опасность для жизни. Фокальные поражения, затра-гивая часть стенки сосуда, могут привести к образо-ванию аневризмы и разрыву сосуда. Сегментные по-ражения влияют по всей окружности, они более рас-пространены и могут привести к стенозу или окклю-зии с дистальным инфарктом.Классификация васкулита -область споров в течение многих лет, конкретные критерии класси-фикации введены лишь относительно недавно. Оценка болезни в настоящее время подвергается дальнейшему пересмотру и доработке. Представлены данные литературы о течении беременности у женщин с системными первичными васкулитами. В настоящее время риск неблагоприятного исхода беременности для больных с системным первичным васкулитом таков: низкая материнская и плодовая смертность (<5-10%), преждевременные роды (до 40%). Таким образом, здоровье плода и матери зависит от активности заболевания и повреждения органов-мишеней во время беременности. Беременность у больных с васкулитом следует рассматривать как высокий риск, требующий тщательного планирования и регулярного мониторинга со стороны акушеров, терапевтов или ревматологов. Важно учитывать возраст матери и время, необходимое для достижения полной, а не частичной ремиссии заболевания. Беременность должна одобряться только тогда, когда васкулит находится в стадии стойкой ремиссии. The literature data about systemic primary vasculitis and pregnancy are presented. The pregnancy in patients with systemic primary vasculitis is characterized by low maternal and fetal mortality (<5-10%) and high premature delivery rate (up to 40%). Pregnancy in patients with vasculitis should be considered as high risk pregnancy requiring careful planning and regular monitoring by obstetricians, internists or rheumatologists who have experience in such special cases. It is important to take into account maternal age and the time required to achieve the total remission. Pregnancy should be approved only in sustained vasculitis remission or in vasculitis with minimal activity for at least 6 months without or with few organ damages.

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Section: беременность у больных с системными первичными васкулитамиunclassified

Systemic primary vasculitis and pregnancy

Voznesenskaja¹,

Litvinenko²,

Blashkiv³

2015

Probl. reprod.

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“…Rheumatic mitral stenosis, the most common heart valve abnormality in pregnancy, is usually well tolerated owing to the pregnancy-related decrease in systemic vascular resistance [115,116]. Patients diagnosed with vasculitides during pregnancy tend to do worse than those who had the condition before pregnancy and were in remission when they conceived [117][118][119]. Many patients who are diagnosed as having vasculitis, have RCVS.…”

Section: Choriocarcinomamentioning

confidence: 99%

Stroke in pregnant and postpartum women

Sidorov

Feng

Caplan

2011

Expert Review of Cardiovascular Therapy

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Ischemic infarcts and hemorrhages are uncommon but dangerous complications of pregnancy. Their etiology is related to physiological changes during pregnancy. The majority of strokes are seen in the third trimester and postpartum and are etiologically related to three conditions: reversible cerebral vasoconstriction syndrome, preeclampsia/eclampsia and cerebral venous thrombosis. The first two conditions are etiologically connected and can lead to ischemic and hemorrhagic events, whereas cerebral sinus thrombosis is mainly related to hypercoagulation and causes venous infarcts and brain hemorrhages. MRI and CT scans are safe to use for diagnosis of stroke in pregnancy, although use of iodine-based contrast may affect thyroid function of the neonate. Management of stroke in pregnancy is specific to cause and depends on management of blood pressure and delivery in preeclampsia/eclampsia, expected management or calcium channel blockers in reversible cerebral vasoconstriction syndrome, and anticoagulation for cerebral sinus thrombosis.

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“…CSS is rare and, despite this being a disease that affects women of childbearing age, there have been very few cases of CSS in pregnancy published in the medical literature [18][19][20][21][22][23][24][25] and it is from these that the following conclusions have been drawn.…”

Section: Churg-strauss Syndromementioning

confidence: 99%

Vasculitis in pregnancy

Foster

D’Cruz

2007

Expert Review of Obstetrics & Gynecology

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This article reviews vasculitis in pregnancy and is relevant to all healthcare professionals working with women of childbearing age. It covers recent developments in the field of vasculitis and pregnancy, summarizes current therapeutic practice and looks toward future challenges in this area. Vasculitis in pregnancy is rare and our knowledge of how to manage these women is limited but expanding. We know that pregnancy can have a disease-modifying effect on autoimmune connective tissue diseases such as vasculitis and that connective tissue disease can have an adverse effect on pregnancy. It is essential that pregnant women with vasculitis are managed to the highest standards of care, in order to prevent negative outcomes not only for the mother but also for the child. This article aims to provide an approach to managing these patients with the best current evidence-based practice.

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Fulminant Pregnancy-Related Churg-Strauss Syndrome

Abstract: Pregnancy has not hitherto been known to influence the course of Churg-Strauss syndrome. We describe a case where relapse occurred in four successive pregnancies. The disease proved fatal in the last pregnancy when aggressive treatment failed to reverse fulminant cardiac disease.

Cited by 29 publications

References 0 publications

Systemic primary vasculitis and pregnancy

Systemic primary vasculitis and pregnancy

Stroke in pregnant and postpartum women

Vasculitis in pregnancy

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