Sugisaki Kota, Sakauchi Michihiro
Department of Rheumatology, Japanese Red Cross Mito Hospital, Ibaraki, Japan.
J Med Cases. 2023 Apr;14(4):118-123. doi: 10.14740/jmc4083. Epub 2023 Apr 30.
Takayasu arteritis (TAK) is a rare vasculitis that often affects young women of childbearing age, and its management during pregnancy poses unique challenges. Limited data exist regarding the safety and efficacy of tocilizumab (TCZ), an interleukin-6 receptor antagonist, in the treatment of TAK during pregnancy. This case report presents a unique and valuable insight into the use of TCZ in pregnant patients with TAK. We report an 18-year-old female patient with TAK who was treated with TCZ during two pregnancies, resulting in positive maternal and neonatal outcomes. However, a newly identified descending aortic aneurysm was noted after the second delivery, highlighting the importance of careful monitoring of vascular lesions in patients with TAK receiving TCZ. Our findings suggest that TCZ has a high safety profile for both the mother and fetus; however, further research and close monitoring are essential for its use in pregnant patients with TAK.
大动脉炎(TAK)是一种罕见的血管炎,常累及育龄期年轻女性,其在孕期的管理带来了独特的挑战。关于白细胞介素-6受体拮抗剂托珠单抗(TCZ)在孕期治疗TAK的安全性和有效性的数据有限。本病例报告提供了关于在患有TAK的孕妇中使用TCZ的独特且有价值的见解。我们报告了一名18岁患有TAK的女性患者,她在两次怀孕期间接受了TCZ治疗,母婴结局均为阳性。然而,在第二次分娩后发现了一个新的降主动脉瘤,这凸显了对接受TCZ治疗的TAK患者仔细监测血管病变的重要性。我们的研究结果表明,TCZ对母亲和胎儿都具有较高的安全性;然而,进一步的研究和密切监测对于其在患有TAK的孕妇中的使用至关重要。