Relapse of colchicine-intolerant, corticosteroid-dependent recurrent idiopathic pericarditis after perigestational discontinuation of anakinra : uncertain safety of anakinra in pregnancy and the need for shared decision-making
© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ..
A nulligravid woman in her mid-20s with colchicine-intolerant, steroid-dependent recurrent idiopathic pericarditis was in remission for 2 years on anakinra monotherapy when she had an unplanned pregnancy. Due to very limited and conflicting data, European Alliance of Associations for Rheumatology and American College of Rheumatology guidelines are equivocal on the use of anakinra in pregnancy, emphasising an individualised approach. Anakinra was discontinued but a month later, in the second month of gestation, the patient had an acute pericarditis flare. A multidisciplinary, patient-centred discussion about the competing risks of infection, obstetric complications and fetal malformations with anakinra versus suboptimally managed recurrent acute pericarditis guided the patient to choosing improved symptom control. Chest pain resolved and CRP normalised after daily anakinra injections were resumed. In the second trimester, the patient had mild COVID-19 infection and streptococcal pharyngitis on anakinra. At 34 weeks gestation, the patient went into preterm labour and had a spontaneous vaginal delivery of a healthy neonate.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
BMJ case reports - 16(2023), 9 vom: 15. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Saad Shaukat, Muhammad Hamza [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 18.09.2023 Date Revised 22.09.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bcr-2023-256180 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362116962 |
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| 245 | 1 | 0 | |a Relapse of colchicine-intolerant, corticosteroid-dependent recurrent idiopathic pericarditis after perigestational discontinuation of anakinra |b uncertain safety of anakinra in pregnancy and the need for shared decision-making |
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| 520 | |a © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a A nulligravid woman in her mid-20s with colchicine-intolerant, steroid-dependent recurrent idiopathic pericarditis was in remission for 2 years on anakinra monotherapy when she had an unplanned pregnancy. Due to very limited and conflicting data, European Alliance of Associations for Rheumatology and American College of Rheumatology guidelines are equivocal on the use of anakinra in pregnancy, emphasising an individualised approach. Anakinra was discontinued but a month later, in the second month of gestation, the patient had an acute pericarditis flare. A multidisciplinary, patient-centred discussion about the competing risks of infection, obstetric complications and fetal malformations with anakinra versus suboptimally managed recurrent acute pericarditis guided the patient to choosing improved symptom control. Chest pain resolved and CRP normalised after daily anakinra injections were resumed. In the second trimester, the patient had mild COVID-19 infection and streptococcal pharyngitis on anakinra. At 34 weeks gestation, the patient went into preterm labour and had a spontaneous vaginal delivery of a healthy neonate | ||
| 650 | 4 | |a Case Reports | |
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| 650 | 4 | |a Contraindications and precautions | |
| 650 | 4 | |a Immunological products and vaccines | |
| 650 | 4 | |a Obstetrics, gynaecology and fertility | |
| 650 | 4 | |a Pericardial disease | |
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