Mekinian A, Costedoat-Chalumeau N, Carbillon L, Coulomb-L'Hermine A, Le Guern V, Masseau A, Lazaro E, Cohen J, Bornes M, Kayem G, Fain O
Service de médecine interne, département inflammation immunopathologie, biothérapie Department (DHU i2B), hôpital Saint-Antoine, AP-HP, université Paris 6, 75012 Paris, France.
Centre de référence maladies auto-immunes et systémiques rares d'île de France, département de médecine interne, hôpital Cochin, AP-HP, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Inserm U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), 75004 Paris, France.
Rev Med Interne. 2018 Feb;39(2):117-121. doi: 10.1016/j.revmed.2017.10.422. Epub 2017 Nov 13.
Chronic intervillositis is a rare condition, which is associated with severe obstetrical outcome and high recurrence rate. Obstetrical adverse events are intrauterine growth restriction, recurrent early miscarriages, intrauterine deaths and prematurity by placental insufficiency. The determination of the extension and the intensity of the chronic intervillositis are not currently standardized. High rates of recurrence have been described, but actually there is no reliable predictive biomarker. No treatment is currently validated, but the use of immunomodulatory drugs could be justified by the possible autoimmune or allo-immune origin. The treatment should be particularly discussed in patients with recurrent and severe obstetrical adverse events and in the presence of severe and massive histological lesions.
慢性绒毛间炎是一种罕见病症，与严重的产科结局及高复发率相关。产科不良事件包括胎儿生长受限、反复早期流产、死胎以及因胎盘功能不全导致的早产。目前，慢性绒毛间炎的病变范围和严重程度判定尚无标准化方法。虽有高复发率的报道，但实际上尚无可靠的预测生物标志物。目前尚无经过验证的治疗方法，但鉴于其可能的自身免疫或同种免疫起源，使用免疫调节药物可能是合理的。对于反复出现严重产科不良事件且存在严重广泛组织学病变的患者，应特别讨论治疗方案。
