Adult Still's disease, a maternal-fetal risk: A case report
DOI:
https://doi.org/10.33448/rsd-v14i12.50482Keywords:
Pregnancy, Adult Still's disease, Pregnancy complications, Arthritis.Abstract
Introduction: Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder of unknown etiology that, when it occurs during pregnancy, poses a clinical challenge due to the risk of obstetric and systemic complications. Objective: To describe the clinical course, diagnostic approach, and multidisciplinary management of a pregnant woman with AJS, highlighting the maternal and perinatal implications. Methodology: A qualitative, descriptive, single-case report study was conducted with retrospective analysis of the electronic medical record following the CARE guidelines, ensuring confidentiality and informed consent. Discussion: SLE in pregnancy poses diagnostic challenges due to its similarity to serious obstetric conditions. in this case, the patient with a history of systemic inflammatory disease and autoimmune hemolytic anemia progressed favorably under specialized management and multidisciplinary follow-up, which allowed close monitoring of the mother-fetus pair and a positive neonatal outcome despite preterm delivery and premature rupture of membranes. Conclusion: ESA during pregnancy requires a high index of suspicion, timely diagnosis, and interdisciplinary management; individualized therapy and continuous monitoring are essential to reduce maternal and fetal morbidity and mortality.
References
Andreoli, L., Bertsias, G. K., Agmon-Levin, N., Brown, S., Cervera, R., Costedoat-Chalumeau, N., Doria, A., Fischer-Betz, R., Forger, F., Moraes-Fontes, M. F., Nelson-Piercy, C., Piette, J. C., Ramsey-Goldman, R., Ruiz-Irastorza, G., Shoenfeld, Y., Stagnaro-Green, A., Tincani, A., Ugarte, A., & Mosca, M. (2017). EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Annals of the Rheumatic Diseases, 76(3), 476–485.
https://doi.org/10.1136/annrheumdis-2016-209770
CARE. (2025). case report guidelines [Internet]. CARE Case Report Guidelines. https://www.care..statement.org/
De Boysson, H., Jamilloux, Y., & Sève, P. (2020). Biologic therapies in adult-onset Still’s disease. Rheumatology, 59(8), 1739–1748.
https://doi.org/10.1093/rheumatology/kez587
De Carolis, S., Cianci, F., Del Sordo, G., Botta, A., Salvi, S., Garofalo, S., Lanzone, A., & De Carolis, M. P. (2019). Adult-onset Still’s disease and pregnancy. Autoimmunity Reviews, 18(9), 102356. https://doi.org/10.1016/j.autrev.2019.102356
Efthimiou, P., Paik, P. K., & Bielory, L. (2006). Diagnosis and management of adult onset Still’s disease. Annals of the Rheumatic Diseases, 65(5), 564–572.
https://doi.org/10.1136/ard.2005.042143
Fautrel, B., Zing, E., Golmard, J. L., et al. (2002). Proposal for a new set of classification criteria for adult-onset Still disease. Medicine, 81(3), 194–200.
https://doi.org/10.1097/00005792-200205000-00003
Feist, E., Mitrovic, S., & Fautrel, B. (2018). Mechanisms, biomarkers and targets for adult-onset Still’s disease. Nature Reviews Rheumatology, 14(10), 603–618. https://doi.org/10.1038/s41584-018-0081-x
Gerfaud-Valentin M, Hot A, Huissoud C, Durieu I, Broussolle C, Seve P. Adult-onset Still’s disease and pregnancy: about ten cases and review of the literature. Rheumatol Int. 2014;34(6):867–71. Disponible en: https://doi.org/10.1007/s00296-013-2765-5
Hosoya S, Sadatsuki M, Izuka S, et al. A case of recurrence of adult-onset Still’s disease in the third trimester: a case report and literature review. BMC Pregnancy Childbirth. 2021;21:163. Disponible en: https://doi.org/10.1186/s12884-021-03648-1
Jorgensen, S. C. J., & Lapinsky, S. E. (2022). Tocilizumab for coronavirus disease 2019 in pregnancy and lactation: A narrative review. Clinical Microbiology and Infection, 28(1), 51–57.https://doi.org/10.1016/j.cmi.2021.08.016
Kitada T, Kadoba K, Watanabe R, Koyama T, Nakayama Y, Taki M, et al. Listeriosis presenting with fever, arthralgia, elevated liver enzymes, and hyperferritinaemia in pregnancy: a critical mimicker of adult-onset Still’s disease. Scand J Rheumatol. 2022;51(1):78–80. Disponible en: https://doi.org/10.1080/03009742.2021.1923149
Martinez-King C, Chung SH, McCartney SA. Adult-onset Still’s disease in pregnancy: Lessons learned and an approach to subsequent pregnancies. Reprod Sci. 2023;30(12):3515–9. Disponible en: https://doi.org/10.1007/s43032-023-01296-8
Olivé A, Holgado S, Valls M. Enfermedad de Still del adulto. Rev Esp Reumatol. 2001;28(1):32–7. Disponible en:https://www.elsevier.es/es-revista-revista-espanola-reumatologia-29-articulo-enfermedad-still-del-adulto-15194
Piñel-Pérez, Carlos Santiago, Gómez-Roso Jareño, María José, Caliendo, Constanza Gabriela, Steinberg-Contreras, Gizelle Helena, & López-Galián, Juan José. (2020). Artritis reumatoide y embarazo. Reporte de un caso y revisión de la bibliografía. Ginecología y obstetricia de México, 88(11), 806-814. Epub 18 de octubre de 2021. http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0300-90412020001100007&lng=es&tlng=es.
Pan V. Newly diagnosed adult-onset Still disease in pregnancy. Obstet Gynecol. 2003;101(5):1112–6. Disponible en: https://doi.org/10.1016/s0029-7844(03)00065-6
Plaçais L, Mekinian A, Bornes M, Poujol-Robert A, Bigé N, Maury E, et al. Adult onset Still’s disease occurring during pregnancy: case-report and literature review. Semin Arthritis Rheum. 2018;47(4):575–7. Disponible en: https://doi.org/10.1016/j.semarthrit.2017.07.003
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Remaud, A., Riviere, S., Lavigne, C., et al. (2014). Pregnancy outcome in adult-onset Still’s disease. Arthritis Care & Research, 66(7), 1098–1104.
https://doi.org/10.1002/acr.22240
Toassi, R. F. C. & Petry, P. C. (2021). Metodologia científica aplicada à área da saúde. (2ed). Editora da UFRGS.
Yin, R. C (2015). O estudo de caso. Editora Bookman.
Yamaguchi, M., Ohta, A., Tsunematsu, T., et al. (1992). Preliminary criteria for classification of adult Still’s disease. The Journal of Rheumatology, 19(3), 424–430.
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Copyright (c) 2025 Claudia Bibiana Peñaranda-Ospina, Cristhian Camilo Velandia-Mosquera, Stephania Vargas-Arrigui, Nicolás Delgado-Garcés, Juan Esteban Grisales-Domínguez, Valeria Llanos-Posso, Melisa Castaño-Rentería
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