title: Chronic histiocytic intervillositis: outcome, associated diseases and treatment in a multicenter prospective study.
abstract: Introduction: In this prospective multicenter study, we aimed to describe (1) the outcome of pregnancy in the case of previous chronic histiocytic intervillositis (CHI), (2) the immunological findings and associated diseases, (3) the treatments, and (4) the factors associated with pregnancy loss.
  
  
  METHODS
  We prospectively included all patients with a prior CHI with ongoing pregnancy between 2011 and 2013.
  
  
  RESULTS
  Twenty-four women (age 34±5 years) were included in this study. An autoimmune disease was present in seven (29%) cases. Twenty-one prospective pregnancies were treated. The number of live births was more frequent comparatively to the previous obstetrical issues (16/24 versus 24/76; p=0.003). Most of the pregnancies were treated (88%), whereas only 13% of previous pregnancies were treated (p<0.05). No difference was found with respect to the pregnancy outcome in the different treatment regimens. In univariate analyses, a prior history of intrauterine death and intrauterine growth restriction and the presence of CHI in prospective placentas were associated with failure to have a live birth.
  
  
  CONCLUSIONS
  In this multicenter study, we show the frequency of the associated autoimmune diseases in CHI, as well as the presence of autoantibodies without characterized autoimmune disease. The number of live births increased from 32% to 67% in the treated pregnancies. Despite the treatment intervention, the risk of preterm delivery remained at 30%. Last, we show that the recurrence rate of an adverse pregnancy outcome persisted at 30% despite treatment intervention.
  
  
  CONCLUSIONS
  CHI is associated with high recurrence rate and the combined regimen seems to be necessary, in particular, in the presence of previous intrauterine death.
authors.affiliation: Université Paris 13 , Bondy, France; AP-HP, Service de médecine interne, Hôpital Jean Verdier, Bondy , France .
authors.forename: Arsène
authors.initials: A
authors.lastname: Mekinian
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
authors.forename: Agathe
authors.initials: A
authors.lastname: Masseau
authors.forename: Angela
authors.initials: A
authors.lastname: Botta
authors.forename: Anastasia
authors.initials: A
authors.lastname: Chudzinski
authors.forename: Arnaud
authors.initials: A
authors.lastname: Theulin
authors.forename: Virginie
authors.initials: V
authors.lastname: Emmanuelli
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Sara
authors.initials: S
authors.lastname: De Carolis
authors.forename: Aurélie
authors.initials: A
authors.lastname: Revaux
authors.forename: Pascale
authors.initials: P
authors.lastname: Nicaise
authors.forename: Françoise
authors.initials: F
authors.lastname: Cornelis
authors.forename: Damien
authors.initials: D
authors.lastname: Subtil
authors.forename: Francois
authors.initials: F
authors.lastname: Montestruc
authors.forename: Martine
authors.initials: M
authors.lastname: Bucourt
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chollet-Martin
authors.forename: Lionel
authors.initials: L
authors.lastname: Carbillon
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
mesh_terms: D000026:Abortion, Habitual / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D002465:Cell Movement; D002824:Chorionic Villi / Q000276:immunology* / Q000473:pathology; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006644:Histiocytes / Q000276:immunology* / Q000473:pathology; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007231:Infant, Newborn; D050498:Live Birth; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D001323:Autoantibodies; D006495:Heparin, Low-Molecular-Weight; D006886:Hydroxychloroquine; D001241:Aspirin; D011241:Prednisone
keywords: Autoimmune disease; chronic histiocytic intervillositis; outcome; treatment