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Postpartum onset and subsequent relapse of eosinophilic granulomatosis with polyangitis

Postpartum onset and subsequent relapse of eosinophilic granulomatosis with polyangitis
Postpartum onset and subsequent relapse of eosinophilic granulomatosis with polyangitis
Eosinophilic granulomatosis with polyangiitis (EGPA) can affect women of childbearing age. However, reports of the disease in the postpartum period are limited. We present a case of postpartum-onset EGPA that went into clinical remission before relapsing in the subsequent postpartum period. Our patient presented with dyspnoea, arthralgia and rash, shown to be eosinophilic vasculitis, 3?days following the birth of her second child. CT of the thorax showed alveolar shadowing and mediastinal lymphadenopathy. She was treated successfully for EGPA with glucocorticoid therapy. She declined maintenance treatment during remission. Off treatment, she remained disease free throughout her next pregnancy. In the postpartum period she relapsed in an almost identical manner, requiring prolonged glucocorticoid therapy, cyclophosphamide and rituximab. This case highlights the importance of maintenance therapy around pregnancy in individuals with EGPA, and the need for careful monitoring of women with a history of EGPA in the postpartum period.
1757-790X
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Curtis, E.M.
92beef1b-f012-4398-861c-e1156b2adfee
Ledingham, J.M
b5d91c84-2943-464c-b777-bae176aaac65
Edwards, M.H.
b81ff294-1d16-4a1b-af14-9374c5989d4c
Curtis, E.M.
92beef1b-f012-4398-861c-e1156b2adfee
Ledingham, J.M
b5d91c84-2943-464c-b777-bae176aaac65

Edwards, M.H., Curtis, E.M. and Ledingham, J.M (2015) Postpartum onset and subsequent relapse of eosinophilic granulomatosis with polyangitis. BMJ Case Reports. (doi:10.1136/bcr-2015-210373). (PMID:26106182)

Record type: Article

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) can affect women of childbearing age. However, reports of the disease in the postpartum period are limited. We present a case of postpartum-onset EGPA that went into clinical remission before relapsing in the subsequent postpartum period. Our patient presented with dyspnoea, arthralgia and rash, shown to be eosinophilic vasculitis, 3?days following the birth of her second child. CT of the thorax showed alveolar shadowing and mediastinal lymphadenopathy. She was treated successfully for EGPA with glucocorticoid therapy. She declined maintenance treatment during remission. Off treatment, she remained disease free throughout her next pregnancy. In the postpartum period she relapsed in an almost identical manner, requiring prolonged glucocorticoid therapy, cyclophosphamide and rituximab. This case highlights the importance of maintenance therapy around pregnancy in individuals with EGPA, and the need for careful monitoring of women with a history of EGPA in the postpartum period.

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e-pub ahead of print date: 23 June 2015
Organisations: MRC Life-Course Epidemiology Unit

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Local EPrints ID: 379158
URI: http://eprints.soton.ac.uk/id/eprint/379158
ISSN: 1757-790X
PURE UUID: 3cac2fa7-9a73-49d4-a86e-0049c5ccc8a3

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Date deposited: 21 Jul 2015 15:58
Last modified: 14 Mar 2024 20:34

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Contributors

Author: M.H. Edwards
Author: E.M. Curtis
Author: J.M Ledingham

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