Therapeutic Efficacy of Leukocytapheresis in a Pregnant Woman with Refractory Adult-onset Still's Disease

Odai, Tsuyoshi; Isozaki, Takeo; Kasama, Tsuyoshi; Ogata, Hiroaki; Kinugasa, Eriko

doi:10.2169/internalmedicine.54.4271

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…In addition, cases of AOSD in which the onset occurs during the perinatal period are rare. A summary of reported cases of AOSD from 1971 onwards in which the onset occurred during the perinatal period is shown in Table (13,14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Of the 22 patients, including the present patient, 20 (90.9%) were treated with corticosteroids.…”

Section: Discussionmentioning

confidence: 93%

Adult-onset Still's Disease during Pregnancy Treated with Tocilizumab

et al. 2022

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A 28-year-old woman exhibited a spiking fever, arthritis, and liver disfunction when she was 22 weeks pregnant. She was diagnosed with adult-onset Still's disease (AOSD). As her condition was resistant to corticosteroid therapy, tocilizumab (TCZ) was selected. The TCZ treatment was effective, and she delivered a healthy child while receiving TCZ treatment. Cases in which AOSD first arises during pregnancy are rare, and there have been no reports of TCZ treatment for AOSD being initiated during pregnancy. Although the safety of TCZ treatment during pregnancy has not been established, it may be effective against severe AOSD that develops during pregnancy.

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Section: Discussionmentioning

confidence: 93%

Adult-onset Still's Disease during Pregnancy Treated with Tocilizumab

et al. 2022

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“…The treatment of AOSD during pregnancy is challenging. Glucocorticoids are a mainstay of treatment for patients with AOSD (31,32), despite the potential increased risk of gestational diabetes, arterial hypertension, intrauterine growth restriction, or pre-term premature rupture of membranes (33)(34)(35)(36). Intravenous immunoglobulin (IVIG) has been reported for the management of AOSD during pregnancy (37), especially for the life-threatening complications.…”

Section: Discussionmentioning

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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“…Die Datenlage zu Anakinra in der Schwangerschaft ist weiterhin gering, bisher gab es in den berichteten Fällen keine Auffälligkeiten, sodass im Falle einer schweren Exazerbation der Erkrankung mit der Notwendigkeit hoher Steroiddosen die Gabe von Anakinra erwogen werden kann [34]. Leukozytenapharese wurde in Einzelfällen erfolgreich bei therapierefraktären Patienten mit AOSD während der Schwangerschaft eingesetzt [35][36][37].…”

Section: Therapieoptionen In Der Schwangerschaftunclassified

Fiebersyndrome: Kinderwunsch und Schwangerschaft

Henes

2017

Akt Rheumatol

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Zusammenfassung Autoinflammatorische Erkrankungen treten meist in der Kindheit oder den jungen Erwachsenenjahren auf und nehmen daher auch Einfluss auf Kinderwunsch/Reproduktion der Patienten. Die Datenlage f?r Fertilit?t und Schwangerschaftsausgang und -komplikationen ist weiterhin sehr eingeschr?nkt, soll in diesem Artikel aber zusammengefasst werden. Grunds?tzlich gilt auch f?r Patienten mit autoinflammatorischen Erkrankungen derselbe Grundsatz wie f?r andere Patienten mit chronisch entz?ndlichen Erkrankungen: Um ein m?glichst geringes Risiko f?r Mutter und Kind zu erm?glichen, sollten die Patienten vor einer Schwangerschaft (ideal: 6 Monate), unter einer mit einer Schwangerschaft zu vereinbarenden Medikation, in stabiler Remission sein.

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Therapeutic Efficacy of Leukocytapheresis in a Pregnant Woman with Refractory Adult-onset Still's Disease

Cited by 9 publications

References 24 publications

Adult-onset Still's Disease during Pregnancy Treated with Tocilizumab

Adult-onset Still's Disease during Pregnancy Treated with Tocilizumab

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

Fiebersyndrome: Kinderwunsch und Schwangerschaft

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