Heart failure, metabolic acidosis, and postoperative multiple organ failure after anesthesia for cesarean section in a patient with Takayasu arteritis: a case report

Chi, Meiying; Qi, Lifeng; Cai, Ailan; Zhang, Yanwei; Li, Fengguang; Jia, Xinquan

doi:10.12891/ceog16552014

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Moreover, Takayasu Arteritis is likely to be overrepresented in this review focusing on vasculitis diagnosed within 6 months post-delivery, because angiographic investigations required to confirm the diagnosis were performed after delivery in all cases [ 17 , 19 , 36 , 39 , 40 , 43 , 49 , 52 , 54 , 59 ]. The risk of intra-uterine growth restriction, the need of close monitoring of Blood Pressure and the anaesthetic management of Takayasu Arteritis during labour have been reviewed elsewhere [ 3 , 61 – 64 ].…”

Section: Discussionmentioning

confidence: 99%

Systemic vasculitis diagnosed during the post-partum period: case report and review of the literature

Demotier

Orquevaux

N’Guyen

2023

matern health, neonatol and perinatol

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Introduction The vasculitis diagnosed specifically in the post-partum period are less well known. We report here such a case followed by a descriptive review of the literature. Case report A 25 year-old French nurse reported abrupt-onset musculoskeletal pain 15 days after delivery of her first infant. Her first pregnancy was uneventful. The physical examination yielded only bilateral conjunctivitis and purpuric eruption of lower limbs, and complementary investigations evidenced pulmonary renal syndrome in connection with the diagnosis of Granulomatosis with Polyangiitis. Methods We screened previous articles in Medline database using keywords (i) “post-partum” or “puerperium” (ii)”peripartum” (iii) “pregnancy” associated with “vasculitis”. Full texts were obtained from case reports or cases series whose title or abstract included keywords of interest (or synonyms). These references were secondarily excluded if the diagnosis of vasculitis was not confirmed or made before or more than 6 months after delivery and if vasculitis occurred only in the new born or affected only the cerebral vasculature or the retina. Results Fifty-six cases of vasculitis diagnosed in the post-partum period were included, 50 (89.3%) were secondary to an immunological process and 44 corresponded to primary vasculitis, 4 were secondary to Systemic Lupus Erythematosus, 1 to cryoglobulinaemia and 1 to cryoglobulinaemia associated with inflammatory bowel disease. The main primary vasculitis diagnosed were Takayasu Arteritis (n = 10), Eosinophilic granulomatosis with polyangiitis (n = 9), Granulomatosis with Polyangiitis (n = 7), Periarteritis Nodosa (n = 5) and Behcet’s disease (n = 4). The first symptom occurred before delivery in 26 (59.1%) and maternal death occurred in 4 (9.1%) out of the 44 primary vasculitis cases. Conclusion The vasculitis diagnosed in the post-partum period were mainly primary vasculitis among patients in whom the diagnosis had not been made during pregnancy. In less than half of cases and as described in ours, there were no reported symptoms before delivery. Therefore, the physicians should pay attention to symptoms and keep a high degree of suspicion for vasculitis before as well as after delivery.

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