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Acute onset of polymyalgia rheumatica in pregnancy
Hiroko Sasaki1, Motoo Washio, Noriyuki Ohara
1Department 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
Background:
Polymyalgia rheumatica is uncommon in young women and remains a diagnostic challenge for pregnant women.
Case:
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.
Conclusion:
The diagnosis of polymyalgia rheumatica is important to properly manage pregnancy.
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