title: New diagnosis of rheumatoid arthritis during the third trimester of pregnancy.
abstract: We report here an unusual case of rheumatoid arthritis presenting for the first time in a 32-week pregnant patient. Despite thorough evaluations from different specialties, the patient's diagnosis went undiscovered originally being attributed to orthopedic issues and then to normal symptoms of pregnancy. The patient's symptoms progressively worsened until she was no longer able to ambulate and complete her daily activities. A primary diagnosis of rheumatoid arthritis is exceedingly rare during pregnancy due to changes in the body's immune system that accommodate the foreign fetus. Also physiologic changes that occur during pregnancy can often cloud the clinical picture of a patient presenting with joint pain and weakness. Nonetheless, a thorough workup should be conducted to rule out underlying rheumatologic disease.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA Department of Medicine, Montefiore Medical Center, Bronx, NY, USA sana.qureshi@med.einstein.yu.edu.
authors.forename: Sana
authors.initials: S
authors.lastname: Qureshi
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Kanzali
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Syed Farhan
authors.initials: SF
authors.lastname: Rizvi
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Niharika
authors.initials: N
authors.lastname: Joolukuntla
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Fomberstein
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third
keywords: autoimmune disorder; cholestasis of pregnancy; pregnancy; rheumatoid arthritis