Pregnancy-Associated Onset of Adult-Onset Still's Disease

Abstract

Objective: This study aims to elucidate the clinical manifestations, diagnostic challenges, and management strategies of Adult-Onset Still’s Disease (AOSD) during pregnancy, leveraging a case series overview and a detailed case report from our center. Study Design: A comprehensive review of 21 published case reports on AOSD diagnosed during pregnancy was conducted, alongside a detailed case report of a patient diagnosed and managed at our center. This study emphasizes the importance of recognizing AOSD in pregnant patients, outlines the therapeutic challenges encountered, and discusses the potential complications arising from the disease and its treatment. Results: The onset of AOSD during pregnancy predominantly occurs in the first or second trimester, with a polycyclic disease course observed in the majority of cases. Management primarily involves corticosteroids and immunosuppressive medications. The case report highlights the complex interplay between AOSD, Hemophagocytic Lymphohistiocytosis (HLH), and pregnancy, illustrating a multidisciplinary approach to management that ensured favorable maternal and fetal outcomes despite the significant challenges. Conclusion: AOSD presents unique diagnostic and therapeutic challenges during pregnancy, requiring careful consideration of maternal and fetal health. Early diagnosis, a multidisciplinary approach to care, and judicious use of immunosuppressive therapy are critical for managing AOSD flares and associate