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dermatomyositis and pregnancy

Kathleen D Kolstad, David Fiorentino, Shufeng Li, Eliza F Chakravarty, Lorinda Chung
OBJECTIVE: The idiopathic inflammatory myopathies dermatomyositis (DM) and polymyositis (PM) are autoimmune diseases that can affect females of childbearing potential. We assessed pregnancy outcomes in DM and PM patients compared with the general obstetric population. METHODS: The Nationwide Inpatient Sample (NIS) (1993-2007) was used to identify delivery-associated hospitalizations in women with DM or PM (DM/PM, n = 853). Controls were from the general obstetric population delivery-associated hospitalizations matched to each case by year of delivery...
June 2018: Seminars in Arthritis and Rheumatism
Shigeo Iijima
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren's syndrome (pSS) tends to result in preterm delivery and low birthweight infants...
August 2018: Journal of Maternal-fetal & Neonatal Medicine
Zhiqiang Zhong, Fuan Lin, Jing Yang, Fengchun Zhang, Xiaofeng Zeng, Xin You
Objective: To examine if patients with PM/DM are at higher risk of complicated pregnancies. Methods: In a retrospective cohort in a large tertiary centre in North China, the outcomes of 144 pregnancies were evaluated in 62 women with PM/DM. Generalized linear mixed effect models were fitted to assess the effect of pregnancy occurring after disease on pregnancy outcomes including preterm birth (PTB), abortion (spontaneous or induced) and normal delivery. Adjustment for confounding factors including parity, maternal age and pregnancy-disease interval were achieved with a multivariable model...
August 1, 2017: Rheumatology
Maria Giovanna Danieli, Chiara Gelardi, Veronica Pedini, Francesco Logullo, Armando Gabrielli
The efficacy of subcutaneous immunoglobulin is reported in several neurological disorders and, more recently, its use has been extended to other inflammatory diseases, such as the idiopathic inflammatory myopathies, including polymyositis and dermatomyositis. Due to the rarity of these disorders, the role of immunoglobulin, administered intravenously or subcutaneously, remains unclear and poorly investigated. We report our experience about the use of subcutaneous immunoglobulin in myositis spectrum disorders, from idiopathic inflammatory myopathies to more complex conditions, such as overlap and cancer-associated myositis or pregnancy...
March 14, 2017: Current Rheumatology Reviews
Tayfun Akalin, Hatice Akkaya, Barış Büke, İbrahim Koçak
Dermatomyositis (DM), a subtype of idiopathic inflammatory myopathies (IIMs), is characterized by skin rash, proximal muscle weakness, and inflammatory infiltrates in the muscle tissue. The peak incidence of the disease is at the age of 50-60 years, and only 14% of the patients with IIMs are estimated to present during reproductive years. Because of the limited pregnancy experience in patients with IIMs, little is known regarding the effects of DM on pregnancy or vice versa. We herein report a 40-year-old woman who developed DM in the second trimester of her pregnancy and did not respond to treatment with methylprednisolone...
2016: Case Reports in Obstetrics and Gynecology
Kelati Awatef, Gallouj Salim, Mernissi Fatima Zahra
There are only few case reports in the literature documenting outcome of pregnancy in patients with DM in contrast with those of other connective tissue diseases especially when dermatomyositis is revealed during pregnancy, most of the publications reported a poor prognosis for both the mother and the fetus, yet, in our case we confirmed the results of the rare recent cases that have tended to show a good outcome, after the treatment with glucocorticoid and immunosuppressant therapy.
2016: Pan African Medical Journal
Joy Wan, Sotonye Imadojemu, Victoria P Werth
The treatment of rheumatic and autoimmune skin disease in women who are pregnant or of childbearing potential can present challenges to the dermatologist. We discuss the current approaches to treating lupus erythematosus, antiphospholipid antibody syndrome, dermatomyositis, morphea and systemic sclerosis, mixed connective tissue disease, rheumatoid arthritis, and autoimmune blistering disease in such patients. In the appropriate setting, topical and systemic corticosteroids, hydroxychloroquine, dapsone, azathioprine, and ultraviolet B phototherapy may be safely and cautiously used during pregnancy...
May 2016: Clinics in Dermatology
E Cozzani, Arianna Fay Agnoletti, F Pappalardo, I Schiavetti, A Torino, A Parodi
It is known that anti-Ro/SSA positivity leads to higher risk of miscarriage and fetal cardiac malformations. Particularly, anti-p200 antibodies against a finer specificity of the Ro/SSA antigen, have been associated with congenital heart block. The aim of the study was to assess the frequency of anti-p200 among female patients with different connective tissue diseases and, among these, the relevance of anti-p200 values in patients with cutaneous diseases compared to systemic diseases. Anti-p200 were investigated in 110 anti-Ro/SSA positive female sera, sent to our laboratory between 2008 and 2014 with suspect of connective disease, by using ELISA testing...
March 2016: Archives of Dermatological Research
Sebastian P Haen, Philipp Stroebel, Alexander Marx, Daniela Suesskind, Falko Fend, Ursula Reichmann, Hans-Georg Kopp, Lothar Kanz, Frank Mayer
BACKGROUND: Rare sites of metastases, atypical symptoms and paraneoplastic syndromes are often neglected or misinterpreted, especially when they represent early symptoms of an underlying malignant disease. Hence, an interdisciplinary approach to these patients is essential to avoid tumor progression and metastatic spread in order to provide curative treatment options to the patients. We here report the case of a young woman presenting with visual loss which led to diagnosis of a thymic carcinoma...
2015: BMC Cancer
Jian S Chen, Christine L Roberts, Judy M Simpson, Lyn M March
OBJECTIVE: To examine pregnancy outcomes and pregnancy-related health service utilization among women with rare autoimmune diseases. METHODS: This population-based cohort study of an Australian obstetric population (2001-2011) used birth records linked to hospital records for identification of rare autoimmune diseases including systemic vasculitis, vasculitis limited to the skin, Sjögren's syndrome, systemic sclerosis, Behçet's disease, polymyositis/dermatomyositis, and other systemic involvement of connective tissue...
December 2015: Arthritis & Rheumatology
Sofia Mateus, Mariana Malheiro, Miguel Perneta Santos, Rui Costa
Dermatomyositis is rare during the reproductive period, but when it does occur, most cases have been reported from the viewpoint of the obstetric management of high-risk pregnancy. In return, there is little information concerning the contribution of pregnancy to the development and course of dermatomyositis. We describe a patient with dermatomyositis that presented after the delivery of a healthy infant. This case, with support from a literature review, suggests that pregnancy could be a trigger or contributor for the development of dermatomyositis...
September 11, 2015: BMJ Case Reports
Katarzyna Leszczyńska, Maciej Chojnicki, Ireneusz Haponiuk, Krzysztof Preis, Katarzyna Ciach, Katarzyna Gierat-Haponiuk, Zbigniew Łajkowski
INTRODUCTION: Complete heart block (third-degree atrioventricular block) is a defect of the conduction system of the heart, in which the impulse generated in the sinoatrial node does not propagate to the ventricles, and thus the latter contract independently of the atria. A third-degree atrioventricular block can be either congenital or acquired. In 60-70% of the cases, the congenital heart block results from destruction of the conduction system of the fetal heart by anti-Ro/SSA and anti-La/SSB antibodies present in maternal serum...
May 2015: Ginekologia Polska
S Živković
Intravenous immunoglobulins (IVIGs) are often used in the treatment of autoimmune disorders and immunodeficiencies, and it has been estimated that neurologic indications can account for up to 43% of IVIG used in clinical practice. In neurologic clinical practice, IVIG is used for acute therapy of newly diagnosed autoimmune disorders or exacerbations of pre-existing conditions, or as long-term maintenance treatment for chronic disorders. IVIG exerts its effects on humoral and cell-based immunity through multiple pathways, without a single dominant mechanism...
May 21, 2015: Acta Neurologica Scandinavica
Moeko Ochiai, Eri Sato, Eiichi Tanaka, Mari Tochihara, Yoko Shimizu, Hikota Osawa, Kumi Sidara, Naoki Sugimoto, Daisuke Hoshi, Yasushi Kawaguchi, Atsuo Taniguchi, Hisashi Yamanaka
A 37-year-old woman with rheumatoid arthritis and interstitial lung disease (ILD) developed clinically amyopathic dermatomyositis (CADM) after achieving pregnancy through in vitro fertilization. She was given oral prednisolone, which improved her respiratory status, and delivered a healthy baby at 35 weeks' gestation. There are few reports of successful outcomes for CADM during pregnancy; to the best of our knowledge, this is the first report of successful delivery in a patient with both CADM and ILD.
March 2017: Modern Rheumatology
Larissa Sayuri Missumi, Fernando Henrique Carlos de Souza, Joelma Queiroz Andrade, Samuel Katsuyuki Shinjo
BACKGROUND: Currently, there are few studies that describe pregnancy in dermatomyositis/polymyositis patients, and they are largely limited to case reports or studies with few samples. OBJECTIVES: Therefore, we describe the pregnancy in a large sample of patients with dermatomyositis/polymyositis and to analyze the outcomes in those who became pregnant during or after disease onset. METHODS: The present single-center study analyzed 98 female patients with idiopathic inflammatory myopathies (60 dermatomyositis and 38 polymyositis patients)...
March 2015: Revista Brasileira de Reumatologia
Fernando H C de Souza, Samuel K Shinjo, Lucas Y S Yamakami, Vilma S T Viana, Edmund C Baracat, Eloisa Bonfá, Clovis A Silva
OBJECTIVES: To assess ovarian reserve markers and anti-corpus luteum (anti-CoL) antibodies in dermatomyositis (DM) patients. METHODS: Forty female DM patients were invited to participate. Exclusion criteria included hormonal contraceptive use within the last six months, neoplasia associations, overlapped systemic autoimmune diseases, current pregnancy, gynaecological surgery and individual choice not to participate. The final experimental group for this cross-sectional study included 16 DM patients and 23 healthy controls, each of whom was evaluated during the early follicular phase of the menstrual cycle...
January 2015: Clinical and Experimental Rheumatology
Nathalie Bleau, Valerie Patenaude, Haim A Abenhaim
OBJECTIVE: The objective of this study is to evaluate the effect of autoimmune disease on the risk of venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) in pregnant women. METHODS: Using the Health Care Cost and Utilization Project, Nationwide Inpatient Sample database from 2003 to 2011, the risk of developing DVT, PE, and VTE among pregnant patients with selected autoimmune diseases was estimated using unconditional logistic regression analysis...
April 2016: Clinical and Applied Thrombosis/hemostasis
Iago Pinal-Fernandez, Albert Selva-O'Callaghan, Andreu Fernandez-Codina, Xavier Martinez-Gomez, Jose Rodrigo-Pendas, Jordi Perez-Lopez, Miquel Vilardell-Tarres
BACKGROUND AND PURPOSE: Idiopathic inflammatory myopathies (IIM) are systemic diseases, characterized by the presence of an inflammatory muscle infiltrate. Although more frequent in women, its relationship with pregnancy has not been extensively studied. Our goal was to analyze the interaction between pregnancy and myositis in a cohort of IIM women from a single center. METHODS: A total of 51 patients from a historical cohort of IIM diagnosed between 1983 and 2013 were interviewed with a specific questionnaire...
October 2014: Seminars in Arthritis and Rheumatism
Maria Angélica M Orione, Clovis A Silva, Adriana M E Sallum, Lúcia M A Campos, Clarissa H Omori, Alfésio L F Braga, Sylvia C L Farhat
OBJECTIVE: To evaluate the influence of exposure to inhaled environmental factors during pregnancy on the diagnosis of juvenile dermatomyositis (DM). METHODS: We performed a case–control study comprising 20 juvenile DM patients and 56 healthy controls matched by age and sex who were residents in the metropolitan region of a large city. A questionnaire assessed demographic data and environmental inhalation exposure during pregnancy (occupational exposure to demolition, chalk, construction and/or quarry dust, paints, varnish, gasoline vapor, and/or battery fluids; stationary sources of inhaled pollution near the mother's home; and maternal tobacco exposure)...
October 2014: Arthritis Care & Research
S I Lee, W H Yoo
Abstract Dermatomyositis (DM) is rare during the reproductive period, but when it does occur most reports have noted that it has an adverse effect on fetal outcome. Conversely, there is little information concerning the contribution of pregnancy to the development and course of DM. We describe here a patient with DM that developed after delivery of an infant and summarize previously documented cases of postpartum-onset DM. This case suggests that pregnancy could be a trigger for the development of DM.
December 2002: Modern Rheumatology
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