Gul Aiysha, Khan Muzamil, Gill Satkarjeet Kaur, Vasudevan Karthiga, Gurmessa Kiya, Tahir Sophia
Obstetrics and Gynecology, Mardan Medical Complex, Mardan, PAK.
Internal Medicine, The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Cureus. 2024 Jul 19;16(7):e64899. doi: 10.7759/cureus.64899. eCollection 2024 Jul.
Rheumatoid arthritis (RA) is extremely uncommon during pregnancy. The alterations in the immune system that occur to support the developing fetus make the onset of RA during this period unlikely. In this case report, we describe a 26-year-old pregnant woman who presented with bilateral symmetrical pain in her hands, wrists, and ankles at 24 weeks of gestation. After a thorough evaluation, she was diagnosed with active RA based on clinical symptoms and laboratory findings, including elevated inflammatory markers, positive RA factor, and anti-cyclic citrullinated peptide antibodies. Treatment was initiated with hydroxychloroquine (HCQ), prednisolone, and paracetamol, resulting in significant symptom improvement and no postpartum complications. The patient gave birth to a healthy baby via vaginal delivery, highlighting the management challenges and outcomes linked to RA during pregnancy.
类风湿关节炎(RA)在孕期极为罕见。为支持发育中的胎儿而发生的免疫系统改变使得在此期间患RA的可能性不大。在本病例报告中,我们描述了一名26岁的孕妇,她在妊娠24周时出现双手、手腕和脚踝双侧对称性疼痛。经过全面评估,根据临床症状和实验室检查结果,包括炎症标志物升高、类风湿因子阳性和抗环瓜氨酸肽抗体阳性,她被诊断为活动性RA。开始使用羟氯喹(HCQ)、泼尼松龙和对乙酰氨基酚进行治疗,症状得到显著改善,且未出现产后并发症。患者经阴道分娩产下一名健康婴儿,突出了孕期RA相关的管理挑战和结局。