Center for Rheumatic Diseases, Mie University Hospital, Japan.
Intern Med. 2022 Jan 15;61(2):143-149. doi: 10.2169/internalmedicine.7924-21. Epub 2021 Jul 30.
We encountered a 30-year-old woman who developed dermatomyositis during pregnancy and was positive for anti-Mi-2 antibodies. She was successfully treated with prednisolone and tacrolimus and delivered a healthy child. We reviewed the cases of idiopathic inflammatory myositis (IIM) that developed during pregnancy that were published after the year 2000 to elucidate the profile of myositis-specific antibodies (MSAs) in them and to evaluate their obstetric outcomes. In cases with IIM that developed during pregnancy, anti-Mi-2, anti-TIF1-g, anti-Jo-1, and anti-EJ antibodies was detected in one case each. The obstetric outcomes of the IIM-complicated pregnancies were poor, especially when complicated with active maternal myositis. Further studies focusing on the possible causal relationships between MSAs and cases with IIM that developed during pregnancy are needed. For better obstetric outcomes, appropriate suppression of the maternal disease activity using immunosuppressants and vigilance regarding the patient's requirement of Caesarean section is important.
我们遇到了一位 30 岁的女性，她在怀孕期间患皮肌炎，抗 Mi-2 抗体阳性。她接受泼尼松龙和他克莫司治疗后成功分娩，且婴儿健康。我们回顾了 2000 年后发表的特发性炎性肌病（IIM）在怀孕期间发病的病例，以阐明其中肌炎特异性抗体（MSAs）的特征，并评估其产科结局。在怀孕期间发病的 IIM 病例中，每种抗体各检测到一例抗 Mi-2、抗 TIF1-g、抗 Jo-1 和抗 EJ 抗体。伴有肌炎的 IIM 妊娠的产科结局较差，尤其是在母体肌炎活动期。需要进一步研究关注 MSAs 与怀孕期间发病的 IIM 之间可能的因果关系。为了获得更好的产科结局，使用免疫抑制剂适当抑制母体疾病活动，以及警惕患者需要剖宫产是很重要的。
