Acute onset of polymyalgia rheumatica in pregnancy.
BACKGROUND
Polymyalgia rheumatica is uncommon in young women and remains a diagnostic challenge for pregnant women.


METHODS
A 28-year-old pregnant woman developed polymyalgia rheumatica in the third trimester. Laboratory investigations revealed elevated erythrocyte sedimentation rate and C-reactive protein levels with normal muscle enzyme levels and seronegativity for rheumatoid factor. Although her symptoms deteriorated as pregnancy progressed, she drastically improved by treatment with prednisone. She underwent cesarean delivery at 39 weeks. She was relapse-free of polymyalgia rheumatica after discontinuation of prednisone on the 50th postoperative day.


CONCLUSIONS
The diagnosis of polymyalgia rheumatica is important to properly manage pregnancy.
Sasaki
Hiroko
H
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, and Department of Obstetrics and Gynecology, Akashi Medical Center, Akashi, Japan. hiro.sasaki@hosp.kobe-u.ac.jp
Washio
Motoo
M
Ohara
Noriyuki
N
Maruo
Takeshi
T
D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002585:Cesarean Section; D005260:Female; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012008:Recurrence; D012307:Risk Factors
D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein; D011241:Prednisone