Pregnancy-Associated Onset of Adult-Onset Still's Disease

This study aims to elucidate the clinical manifestations, diagnostic challenges, and management strategies of adult-onset Still's disease (AOSD) during pregnancy, leveraging a case series overview and a detailed case report from our center. A comprehensive review of 21 published case reports o...

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Bibliographic Details
Published in:	American journal of perinatology reports Vol. 14; no. 2; pp. e145 - e155
Main Authors:	Zayat, Nawras, Arora, Avish, O'Brien, Joselle, Bal, Japjot, Sugarman, Rebekah, Rivera, Leeshun, Shamshirsaz, Amir, Vani, Kavita, Mastrogiannis, Dimitrios S
Format:	Journal Article
Language:	English
Published:	United States Thieme Medical Publishers, Inc 01-04-2024
Subjects:	adult-onset Still's disease Anakinra and pregnancy disorders hemophagocytic lymphohistiocytosis macrophage activation syndrome management of AOSD during pregnancy pregnancy complications rheumatology disorders macrophage activation syndrome rheumatology hemophagocytic lymphohistiocytosis pregnancy complications Anakinra and pregnancy management of AOSD during pregnancy adult-onset Still's disease
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Summary:	This study aims to elucidate the clinical manifestations, diagnostic challenges, and management strategies of adult-onset Still's disease (AOSD) during pregnancy, leveraging a case series overview and a detailed case report from our center. A comprehensive review of 21 published case reports on AOSD diagnosed during pregnancy was conducted, alongside a detailed case report of a patient diagnosed and managed at our center. This study emphasizes the importance of recognizing AOSD in pregnant patients, outlines the therapeutic challenges encountered, and discusses the potential complications arising from the disease and its treatment. The onset of AOSD during pregnancy predominantly occurs in the first or second trimester, with a polycyclic disease course observed in most cases. Management primarily involves corticosteroids and immunosuppressive medications, balancing the disease control with potential pregnancy complications. The case report highlights the complex interplay between AOSD, hemophagocytic lymphohistiocytosis, and pregnancy, illustrating a multidisciplinary approach to management that ensured favorable maternal and fetal outcomes despite the significant challenges. AOSD presents unique diagnostic and therapeutic challenges during pregnancy, requiring careful consideration of maternal and fetal health. Early diagnosis, a multidisciplinary approach to care, and judicious use of immunosuppressive therapy are critical for managing AOSD flares and associated complications. Further research is necessary to optimize care for this rare condition in the context of pregnancy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	2157-6998 2157-7005
DOI:	10.1055/a-2318-0305