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皮肌炎和多发性肌炎患者的妊娠结局

Pregnancy outcomes in dermatomyositis and polymyositis patients.

作者信息

Missumi Larissa Sayuri, Souza Fernando Henrique Carlos de, Andrade Joelma Queiroz, Shinjo Samuel Katsuyuki

机构信息

Departamento de Reumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.

Departamento de Reumatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.

出版信息

Rev Bras Reumatol. 2015 Mar-Apr;55(2):95-102. doi: 10.1016/j.rbr.2014.10.001. Epub 2014 Nov 7.

Abstract

BACKGROUND

Currently, there are few studies that describe pregnancy in dermatomyositis/polymyositis patients, and they are largely limited to case reports or studies with few samples.

OBJECTIVES

Therefore, we describe the pregnancy in a large sample of patients with dermatomyositis/polymyositis and to analyze the outcomes in those who became pregnant during or after disease onset.

METHODS

The present single-center study analyzed 98 female patients with idiopathic inflammatory myopathies (60 dermatomyositis and 38 polymyositis patients). They were interviewed to obtain obstetric antecedent and demographic data from June 2011 to June 2012.

RESULTS

Seventy-eight (79.6%) of the 98 patients had obstetric histories. Six polymyositis and 9 dermatomyositis patients became pregnant after disease onset. The pregnancy outcomes in these cases were good, except in the following cases: 1 disease reactivation, 1 intrauterine growth retardation, 1 diabetes mellitus, 1 hypertension, 1 hypothyroidism, and 2 fetal losses (same patient). Moreover, 2 patients developed dermatomyositis during pregnancy and 4 (2 polymyositis and 2 dermatomyositis) during the postpartum period with good control after glucocorticoid and immunosuppressant therapy.

CONCLUSIONS

The adverse obstetric events were related to clinical intercurrences and the pregnancy does not seem to carry a worse prognosis specifically in disease (for example: disease relapsing). Moreover, dermatomyositis or polymyositis onset during pregnancy or the postpartum period had good outcome after drug therapy.

摘要

背景

目前,描述皮肌炎/多发性肌炎患者妊娠情况的研究较少,且大多局限于病例报告或样本量少的研究。

目的

因此,我们描述了一大群皮肌炎/多发性肌炎患者的妊娠情况,并分析了疾病发作期间或之后怀孕患者的结局。

方法

本单中心研究分析了98例特发性炎性肌病女性患者(60例皮肌炎患者和38例多发性肌炎患者)。在2011年6月至2012年6月期间对她们进行访谈以获取产科病史和人口统计学数据。

结果

98例患者中有78例(79.6%)有产科病史。6例多发性肌炎患者和9例皮肌炎患者在疾病发作后怀孕。这些病例的妊娠结局良好,但以下情况除外:1例疾病复发、1例胎儿宫内生长受限、1例糖尿病、1例高血压、1例甲状腺功能减退以及2例胎儿丢失(同一患者)。此外,2例患者在孕期发生皮肌炎,4例(2例多发性肌炎和2例皮肌炎)在产后发生,经糖皮质激素和免疫抑制剂治疗后病情得到良好控制。

结论

不良产科事件与临床并发情况有关,妊娠似乎并不会特别加重疾病的预后(例如:疾病复发)。此外,孕期或产后发生的皮肌炎或多发性肌炎经药物治疗后预后良好。

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