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New-Onset Rheumatoid Arthritis in Pregnancy: A Case Report
Aiysha Gul1, Muzamil Khan2, Satkarjeet Kaur Gill3
1Obstetrics and Gynecology, Mardan Medical Complex, Mardan, PAK.
Cureus
|August 21, 2024
Summary
This case report details a rare instance of rheumatoid arthritis (RA) onset during pregnancy. Effective treatment led to symptom relief and a healthy delivery, offering insights into managing RA in expectant mothers.
Area of Science:
- Obstetrics and Gynecology
- Rheumatology
- Immunology
Background:
- Rheumatoid arthritis (RA) onset during pregnancy is exceptionally rare due to immune system adaptations supporting fetal development.
- Pregnancy-induced immune modulation typically suppresses autoimmune conditions, making new RA diagnoses unlikely.
Observation:
- A 26-year-old pregnant woman at 24 weeks gestation presented with acute bilateral symmetrical joint pain in hands, wrists, and ankles.
- Clinical presentation included elevated inflammatory markers, positive rheumatoid factor (RA factor), and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Findings:
- The patient was diagnosed with active rheumatoid arthritis during her pregnancy.
- Treatment with hydroxychloroquine (HCQ), prednisolone, and paracetamol resulted in significant symptom improvement.
- The patient experienced no postpartum complications and delivered a healthy baby via vaginal delivery.
Implications:
- This case underscores the possibility of RA onset during pregnancy, despite its rarity.
- Successful management with specific medications demonstrates feasible treatment options for pregnant women with RA.
- Highlights the importance of vigilant diagnosis and tailored therapeutic strategies for autoimmune diseases in pregnancy.
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