New diagnosis of rheumatoid arthritis during the third trimester of pregnancy

被引:4
作者
Qureshi, Sana [1 ,2 ]
Kanzali, Mahsa [1 ,2 ]
Rizvi, Syed Farhan [1 ,2 ]
Joolukuntla, Niharika [1 ,2 ]
Fomberstein, Barry [1 ,2 ]
机构
[1] Albert Einstein Coll Med, Dept Med, Wakefield Campus, Bronx, NY 10461 USA
[2] Montefiore Med Ctr, Dept Med, Bronx, NY 10467 USA
关键词
autoimmune disorder; cholestasis of pregnancy; pregnancy; rheumatoid arthritis;
D O I
10.1177/1745505716661724
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
We report here an unusual case of rheumatoid arthritis presenting for the first time in a 32-week pregnant patient. Despite thorough evaluations from different specialties, the patient's diagnosis went undiscovered originally being attributed to orthopedic issues and then to normal symptoms of pregnancy. The patient's symptoms progressively worsened until she was no longer able to ambulate and complete her daily activities. A primary diagnosis of rheumatoid arthritis is exceedingly rare during pregnancy due to changes in the body's immune system that accommodate the foreign fetus. Also physiologic changes that occur during pregnancy can often cloud the clinical picture of a patient presenting with joint pain and weakness. Nonetheless, a thorough workup should be conducted to rule out underlying rheumatologic disease.
引用
收藏
页码:407 / 411
页数:5
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共 20 条
[11]   Epidemiology and estimated population burden of selected autoimmune diseases in the United States [J].
Jacobson, DL ;
Gange, SJ ;
Rose, NR ;
Graham, NMH .
CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY, 1997, 84 (03) :223-243
[12]   The immunology of pregnancy: Regulatory T cells control maternal immune tolerance toward the fetus [J].
La Rocca, Claudia ;
Carbone, Fortunata ;
Longobardi, Salvatore ;
Matarese, Giuseppe .
IMMUNOLOGY LETTERS, 2014, 162 (01) :41-48
[13]   Is the Incidence of Rheumatoid Arthritis Rising? Results From Olmsted County, Minnesota, 1955-2007 [J].
Myasoedova, Elena ;
Crowson, Cynthia S. ;
Kremers, Hilal Maradit ;
Therneau, Terry M. ;
Gabriel, Sherine E. .
ARTHRITIS AND RHEUMATISM, 2010, 62 (06) :1576-1582
[14]   The Contribution of Macrophages to Normal and Pathological Pregnancies [J].
Nagamatsu, Takeshi ;
Schust, Danny J. .
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 2010, 63 (06) :460-471
[15]   Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis [J].
Robinson, Dionne P. ;
Klein, Sabra L. .
HORMONES AND BEHAVIOR, 2012, 62 (03) :263-271
[16]   Prevalence of Specific Types of Arthritis and Other Rheumatic Conditions in the Ambulatory Health Care System in the United States, 2001-2005 [J].
Sacks, Jeffrey J. ;
Luo, Yao-Hua ;
Helmick, Charles G. .
ARTHRITIS CARE & RESEARCH, 2010, 62 (04) :460-464
[17]   Th1/Th2/Th17 and Regulatory T-Cell Paradigm in Pregnancy [J].
Saito, Shigeru ;
Nakashima, Akitoshi ;
Shima, Tomoko ;
Ito, Mika .
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 2010, 63 (06) :601-610
[18]   Immunoglobulin G galactosylation and sialylation are associated with pregnancy-induced improvement of rheumatoid arthritis and the postpartum flare: results from a large prospective cohort study [J].
van de Geijn, Fleur E. ;
Wuhrer, Manfred ;
Selman, Maurice H. J. ;
Willemsen, Sten P. ;
de Man, Yael A. ;
Deelder, Andre M. ;
Hazes, Johanna M. W. ;
Dolhain, Radboud J. E. M. .
ARTHRITIS RESEARCH & THERAPY, 2009, 11 (06)
[19]   Pregnancy and the erythrocyte sedimentation rate [J].
van den Broek, NR ;
Letsky, EA .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2001, 108 (11) :1164-1167
[20]   A critical role for murine complement regulator Crry in fetomaternal tolerance [J].
Xu, CG ;
Mao, DL ;
Holers, VM ;
Palanca, B ;
Cheng, AM ;
Molina, H .
SCIENCE, 2000, 287 (5452) :498-501