A woman with rheumatoid arthritis whose condition did not improve during pregnancy.
BACKGROUND
A 25-year-old woman with a 3-year history of rheumatoid arthritis presented 6 months before her first planned pregnancy. At the time of presentation, she was being successfully treated with infliximab and methotrexate. During her pregnancy, the patient discontinued infliximab and methotrexate and her arthritis relapsed. She was treated with low-dose prednisone, sulfasalazine, nimesulide, and intra-articular corticosteroid injections. Oligohydramnios developed at gestational week 18.


METHODS
Laboratory testing, ultrasonography of the fetus and of the patient's affected joints.


METHODS
Active arthritis during pregnancy and oligohydramnios suspected to be caused by nimesulide.


RESULTS
Low-dose oral prednisone, sulfasalazine, repeated intra-articular corticosteroid injections. Infliximab and methotrexate were restarted immediately after delivery.
Østensen
Monika
M
Department of Rheumatology and Clinical Immunology and Allergology, University of Berne, Switzerland. monika.ostensen@insel.ch
Raio
Luigi
L
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012008:Recurrence; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents