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他克莫司联合糖皮质激素治疗大动脉炎伴抗磷脂抗体综合征一例并文献复习

Successful pregnancies in a patient with Takayasu arteritis and antiphospholipid syndrome, maintained on infliximab corticosteroid-free regimen: case-based review.

机构信息

Clinic of Allergy and Immunology, University Clinical Center of Serbia, Koste Todorovica 2, 11000, Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Rheumatol Int. 2024 Jul;44(7):1359-1367. doi: 10.1007/s00296-023-05440-0. Epub 2023 Sep 1.

DOI:10.1007/s00296-023-05440-0
PMID:37653060
Abstract

Takayasu arteritis (TA) is a large vessel vasculitis affecting predominantly females below the age of 40. Patients with TA seem to be at increased risk for adverse pregnancy outcomes, resulting in mother or child complications. Although few studies analyzed the presence of antiphospholipid antibodies (APLA) in TA patients, an association between antiphospholipid syndrome (APS) and TA is rarely reported in the literature, mainly in the form of case reports. In fact, very few data regarding pregnancy outcomes in patients with TA and APS are available. An active form of Crohn's disease (CD) might be another risk factor strongly affecting the fertility rate. Here, we would like to present a 33-year-old woman with TA, double-positive APS and Crohn's disease (CD). The report is followed by the literature review of the association of APLA and/or APS with TA, focusing on analyzing the pregnancy outcomes. To our knowledge, this is the first case describing two successful, naturally occurring pregnancies, in a patient suffering from TA, APS and CD, and maintained on infliximab, azathioprine, and a corticosteroid-free regimen.

摘要

Takayasu 动脉炎(TA)是一种主要影响 40 岁以下女性的大血管血管炎。TA 患者似乎有更高的不良妊娠结局风险,导致母婴并发症。尽管少数研究分析了 TA 患者抗磷脂抗体(APLA)的存在,但抗磷脂综合征(APS)与 TA 之间的关联在文献中很少报道,主要以病例报告的形式出现。事实上,关于 TA 和 APS 患者的妊娠结局的数据非常有限。活动期克罗恩病(CD)可能是另一个强烈影响生育能力的风险因素。在这里,我们将介绍一位 33 岁的女性,她患有 TA、APS 和克罗恩病(CD)双重阳性。报告后对 APLA 和/或 APS 与 TA 的关联进行文献回顾,重点分析妊娠结局。据我们所知,这是首例描述 TA、APS 和 CD 患者在接受英夫利昔单抗、硫唑嘌呤和无皮质类固醇治疗方案下成功自然妊娠两次的病例。

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Successful pregnancies in a patient with Takayasu arteritis and antiphospholipid syndrome, maintained on infliximab corticosteroid-free regimen: case-based review.他克莫司联合糖皮质激素治疗大动脉炎伴抗磷脂抗体综合征一例并文献复习
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本文引用的文献

1
Pregnancy outcomes in Takayasu arteritis patients: a systematic review and meta-analysis.Takayasu 动脉炎患者的妊娠结局:系统评价和荟萃分析。
Sci Rep. 2023 Jan 11;13(1):546. doi: 10.1038/s41598-023-27379-9.
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Comprehensive Analysis of the HLA Class I and the HLA Class II Alleles in Patients with Takayasu Arteritis: Relationship with Clinical Patterns and Prognosis.
大动脉炎患者 HLA Ⅰ类和 HLA Ⅱ类等位基因的综合分析:与临床表型和预后的关系。
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Pregnancy outcome predictors in antiphospholipid syndrome: A systematic review and meta-analysis.抗磷脂综合征的妊娠结局预测因素:系统评价和荟萃分析。
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2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis.2021 年美国风湿病学会/脉管炎基金会巨细胞动脉炎和 Takayasu 动脉炎管理指南。
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Takayasu arteritis in an adolescent with Crohn's disease.青少年克罗恩病并发 Takayasu 动脉炎。
Rheumatol Int. 2022 Mar;42(3):563-570. doi: 10.1007/s00296-021-04869-5. Epub 2021 Apr 27.
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Pregnancy Outcomes in Systemic Vasculitides.系统性血管炎的妊娠结局。
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Analysis of risk factors for complications and adverse obstetrical outcomes in women with Takayasu arteritis: a French retrospective study and literature review.高安动脉炎女性患者并发症及不良产科结局的危险因素分析:一项法国回顾性研究及文献综述
Clin Rheumatol. 2020 Sep;39(9):2707-2713. doi: 10.1007/s10067-020-05024-4. Epub 2020 Mar 23.
9
Pregnancy and Takayasu arteritis: case-based review.妊娠与高安动脉炎:基于病例的综述
Rheumatol Int. 2020 May;40(5):799-809. doi: 10.1007/s00296-019-04499-y. Epub 2019 Dec 19.
10
2018 Update of the EULAR recommendations for the management of large vessel vasculitis.2018 年版 EULAR 大血管血管炎管理建议更新。
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