Table 3 Vasculitis diagnosed in the post-partum period and related to an immunological process
References | Year | Country | Diagnosis | Description of Symptoms associated with vasculitides | First symptom Onset | Pregnancy complications | Outcome |
|---|---|---|---|---|---|---|---|
Berman et al. [11] | 2018 | United States | Microscopic polyangiitis | persistent microscopic hematuria and proteinuria; hemoptysis and bilateral infiltrates on chest radiography | b.d | chorioamnionitis; postpartum hemorrhage | Favourable with: - VVECMO - corticosteroids - plasma exchange - rituximab |
Hiwarkar et al. [12] | 2010 | United Kingdom | Behcet’s Disease | lower limb deep vein and intracardiac thrombosis; mouth aphthous ulcers; folliculitis and livedo reticularis | 10 d p.d | not specified | Favourable with: - anticoagulation - thrombolysis - corticosteroids |
M’Rad et al. [13] | 1989 | Tunisia | Granulomatosis with Polyangiitis | fever; rhinitis, conjunctivitis; multiple opacities on chest radiography; vesicular then purpuric rash; mouth, nose and gastric ulcers; hemoptysis | 2 w p.d | none | Fatal |
Tocut et al. [14] | 2018 | Israel | Cryoglobulinaemia associated vasculitis | dyspnea; leg edema; abdominal pain; hematuria and acute renal failure; purpura and peripheral neuropathy | 2 w p.d | preeclampsia | Fatal |
Miyata et al.a [15] | 1994 | Japan | Henoch-Schönlein purpura | hematuria; purpura; arthralgia and melena | b.d | none | Partially favourable with - corticosteroids |
Trüeb et al. [16] | 1999 | Switzerland | Periarteritis Nodosa | necrotic ulceration of right breast; painful nodules of limbs sometimes leading to ulcer and acral necrosis of the left ring finger | 1–3 m p.d | none | Favourable with: - corticosteroids |
Lumbreras-Marquez et al. [17] | 2018 | Mexico | Takayasu arteritis | arterial hypertension; holosystolic murmur in the pulmonary area | b.d | chronic hypertension; caesarean delivery | Favourable with: -antihypertensive drugs |
Bunker et al. [18] | 2015 | United States | Microscopic polyangiitis | persistent microscopic hematuria and proteinuria; dyspnea; hemoptysis; bilateral infiltrates on chest radiography and anaemia | b.d | none | Favourable with: - mechanical ventilation - corticosteroids - plasma exchange - rituximab |
Singh et al. [19] | 2020 | India | Takayasu arteritis | arterial hypertension and differential blood pressure in both arms | b.d | chronic hypertension; preeclampsia; anhydramnios; IUGR, preterm and caesarean delivery | Favourable with: -antihypertensive drugs |
Metha et al. [20] | 2016 | United States | Eosinophilic granulomatosis with polyangiitis | asthma; chronic sinusitis; nasal polyposis; dyspnea; left lower extremity weakness and pain; hypereosinophilia; bilateral lung consolidations with pleural and pericardial effusions on CT scan; myocarditis on MRI, cardiogenic shock, ventricular fibrillation | b.d | none | Favourable with: - dobutamine - resuscitation - implantable cardioverter-defibrillator - corticosteroids - cyclophosphamide then azathioprine |
Edwards et al. [21] | 2015 | United Kingdom | Eosinophilic granulomatosis with polyangiitis | asthma; dyspnea; arthralgia; nodular erythematous rash; fever and rigors; nausea and abdominal pain; hypereosinophilia and alveolar shadowing plus mediastinal lymphadenopathy on CT scan | 3 d p.d | not specified | Favourable with: - corticosteroids - azathioprine -cyclophosphamide then rituximab |
Fason et al. [22] | 2004 | United States | Kawasaki Disease | fever;erythematous and pustular rash; lymphadenopathy; conjunctivitis; glossitis and cheilitis; desquamation of palm and soles | 3 w p.d | none | Favourable with: - intravenous immunoglobulin |
El Hajoui et al.a [23] | 2002 | Morocco | Behcet’s Disease | arthralgia, mouth and vulvar aphthous ulcers, erythema nodosum, superior vena cava syndrome | p.d | none | Favourable with: - corticosteroids |
Von Kemp et al. [24] | 2019 | Belgium | Eosinophilic granulomatosis with polyangiitis | asthma, sinusitis, fever; arthralgia; orthopnea; purpura hypereosinophilia; myocarditis on MRI; intracardiac thrombosis | 3 w p.d | none | Favourable with: - anticoagulation - corticosteroids - cyclophosphamide then azathioprine |
Mackworth Young et al. [25] | 1984 | United Kingdom | Granulomatosis with Polyangiitis | headache; conjunctivitis; rhinitis with midline necrosis; fever; nephrotic syndrome with pitting ankle edema; anaemia; rounded opacity infiltrates on chest radiography; splinter haemorraghe of nails; purpura and peripheral neuropathy | 1 m p.d | none | Favourable with: - corticosteroids - cyclophosphamide |
Hubscher et al. [26] | 1984 | Argentina | Pulmonary Vasculitis associated with Systemic Lupus erythomatosus | right ventricular heart failure; pulmonary embolism; | 7 d p.d | proteinuria | Fatal (autoptic diagnosis |
Tait et al. [27] | 1955 | New Zealand | Periarteritis Nodosa | arthralgia; fever; back and abdominal pain; diarrhea; pelvic abscess; hematuria; delirium; dyspnea; pericarditis; oedema; oliguria; bloody stools and hemoptysis and peripheral neuropathy | 6 w b.d | none | Fatal (autoptic diagnosis) |
Bolognesi et al. [28] | 1955 | Italy | Henoch-Schönlein purpura | arthralgia; fever; purpuric skin lesions, keratitis | 1 d p.d | none | Spontaneously favourable |
Damian et al. [29] | 2018 | Romania | Periarteritis Nodosa | fever; abdominal pain; aseptic peritonitis; ileus; ovary ischaemia; cutaneous nodules and celiac arteris stenosis | 2–4 d p.d | uneventful twin pregnancy after ovarian stimulation; caesarean delivery | Favourable with: - corticosteroids - immunoglobulin therapy - cyclophosphamide then azathioprine |
Nolan et al. [30] | 1990 | United States | Kawasaki Disease | peripartum myocardial infarction | 1 d b.d | none | Not specified |
Wilks et al. [31] | 1993 | United States | Henoch-Schönlein purpura | abdominal pain, purpuric skin lesions, arthralgia | 10 d p.d | eclampsy; preterm delivery | Favourable with: - corticosteroids |
Habib et al. [32] | 1996 | United States | Granulomatosis with Polyangiitis | sinusitis; granulomatous rhinitis; dyspnea; opacity on chest radiography; microscopic hematuria | 2 y b.d | none | Favourable with: - corticosteroids - cyclophosphamide |
Miller et al. [33] | 1975 | United States | Cutaneous leukocytoclastic angiitis | fever; myalgia; arthritis then painful cutaneous nodulesb | 4 m b.d | none | Spontaneously favourable |
Hirsh et al. [34] | 1980 | United States | Vasculitis associated with cryoglobulinaemia and/or inflammatory bowel disease | fever; right upper quadrant pain; ascites and liver failure due to liver infarctions; pruritic purpuric rash of the lower extremities | 7 d b.d | caesarean delivery for ineffective labor | Favourable with: - corticosteroids |
Komaba et al. [35] | 2007 | Japan | Behcet’s Disease | recurrent oral aphthae; genital ulcerations; acneiform eruptions then nephrotic syndrome and extensive peripheral, iliofemoral, and caval thrombosis | b.d | not specified | Favourable with: - anticoagulation - surgical thrombectomy - corticosteroids |
Aoussar et al.a [36] | 2007 | Morocco | Takayasu arteritis | decreased brachial artery pulse; difference of > 10 mmHg in systolic blood pressure between arms; bruit over carotid, femoral and renal arteries; narrowing of carotid arteries | p.d | not specified | Favourable with: - corticosteroids |
Malilolos Perez et al. [37] | 1982 | Spain | Periarteritis Nodosa | postpartum myocardial infarction and stroke | 7 d p.d | preeclampsy; preterm delivery | Favourable with: - corticosteroids - cyclophosphamide |
Stark et al. [38]a | 1997 | United Kingdom | Behcet’s Disease | recurrent orogenital ulcers and positive pathergy reaction. b | 3 m b.d | caesarean delivery | Not specified |
Giles et al. [39] | 1986 | Australia | Takayasu arteritis | systolic ejection murmur at the left sternal edge; weak femoral pulses; stenosis of abdominal aorta, renal and mesenteric arteries | b.d | chronic hypertension; preterm and caesarean delivery | Not specified |
Umeda et al. [40] | 2003 | Japan | Takayasu arteritis | incidental finding of abdominal aorta aneurysm during pregnancy | b.d | none | Not specified |
Rubin et al. [41] | 1994 | Canada | Pulmonary Vasculitis associated with Systemic Lupus erythomatosus | dyspnea; right Ventricular Heart Failure | 2 d p.d | chronic hypertension; preeclampsy; preterm and caesarean delivery | Fatal (autoptic diagnosis) |
Diamanti et al. [42] | 2014 | Italy | Eosinophilic granulomatosis with polyangiitis | asthma; rhinitis; sinusitis; mononeuritis multiplex; hypereosinophilia and cervical spinal intradural haemorrhage | b.d | not specified | Favourable with: - corticosteroids - rituximab |
Nicolas et al. [43] | 2005 | France | Takayasu arteritis | abdominal pain, headache; transient brachiofacial paralysis; hypertension; dyspnea; decreased brachial artery pulse; difference of > 10 mmHg in systolic blood pressure between arms; bruit over carotid and stenosis of carotid and subclavian arteries | 2 y b.d | not specified | Favourable with: - corticosteroids |
Ogasawara et al. [44] | 1995 | Japan | Eosinophilic granulomatosis with polyangiitis | asthma; fever; hypereosinophilia; pulmonary infiltrates and mononeuritis | 3 m p.d | none | Favourable with: - corticosteroids |
Bessias et al. [45] | 2005 | Greece | Granulomatosis with Polyangiitis | hemoptysis; cough; right leg pain; bilateral parenchymal infiltrates on chest radiography and limb ischaemia due to recurrent arterial thrombosis | b.d | preterm and caesarean delivery | Favourable with: - corticosteroids - cyclophosphamide - leg amputation |
Corradi et al. [46] | 2009 | Italy | Eosinophilic granulomatosis with polyangiitis | asthma; fever; polyarthralgia; chest pain; skin petechiae; left ventricular dysfunction; bilateral alveolointerstitial infiltrates on chest radiography; hypereosinophilia | 2–8 w p.d | none | Favourable with: - corticosteroids - left ventricular heart assistance device - heart transplantation |
Sahni et al. [47] | 2005 | India | Granulomatosis with Polyangiitis | cough; fever; rhinitis; multiple nodular parenchymal opacities on chest radiography; sinusitis | 2 m b.d | none | Favourable with: - corticosteroids - cyclophosphamide |
Casellas et al. [48] | 1993 | Spain | Buerger’s disease | raynaud's disease with distal necrosis of the middle finger of the right hand; absence of left radial and pedal pulse; multiple stenoses and screwdriver lesions in radial, cubital, and palmar arches | 9 y b.d | IUGR, preterm and caesarean delivery | Not specified |
Gasch et al. [49] | 2009 | Spain | Takayasu arteritis | fever; aneurysms of abdominal aorta and left subclavian artery; stenosis of carotid arteries | 10 d p.d | uneventful twin pregnancy | Favourable with: - corticosteroids - abdominal aneurysm surgery |
Borahay et al. [50] | 2009 | United States | Cutaneous vasculitis associated with Systemic Lupus erythomatosus | fever; purpuric patchy lesion of hands and feet | 1 d p.d | eclampsy; caesarean delivery | Favourable with: - corticosteroids - hydroxychloroquine |
Lima et al. [51] | 1995 | United Kingdom | Granulomatosis with Polyangiitis | Sinusitis; sore throat; arthralgia; itchy ears; fever; sweats | 6 w p.d | not specified | Favourable with: - corticosteroids - azathioprine |
Bharuthram et al. [52] | 2020 | South Africa | Takayasu arteritis | bruit over carotid; right carotid and both femoral arteries stenosis and thoracic aorta and right subclavian artery dilatations | b.d | preterm delivery | Favourable with: - corticosteroids - azathioprine |
Cooper et al. [53] | 1970 | United Kingdom | Granulomatosis with Polyangiitis | epistaxis; rhinitis; deafness, facial palsy; cavitary lesion on chest radiography | 1 m p.d | not specified | Favourable with: - corticosteroids - azathioprine |
Dey et al. [54] | 2015 | India | Takayasu arteritis | arterial hypertension; upper limb pulselessness with unrecordable blood pressure; carotid and subclavian arteries stenosis | 6 m b.d | none | Not Specified |
Hiyama et al. [55] | 2000 | Japan | Eosinophilic granulomatosis with polyangiitis | asthma; fever; abdominal pain; diarrhea; hypereosinophilia; bilateral micronodular pulmonary infiltrates and mononeuritis multiplex | 4 w p.d | none | Favourable with: - corticosteroids |
Abdul-Haj et al. [56] | 1961 | United States | Eosinophilic granulomatosis with polyangiitis | fever; cough; asthma, pleural and pericardial effusion; dyspnea and hypereosinophilia | 2 y b.d | none | Fatal (autoptic diagnosis) |
Uchida et al. [57] | 1994 | Japan | Eosinophilic granulomatosis with polyangiitis | rhinitis; asthma; bilateral pulmonary infiltrates; eosinophilia; mononeuritis multiplex; abdominal pain and diarrhea | b.d | not specified | Favourable with: - corticosteroids |
Siegler et al. [58] | 1965 | United States | Periarteritis Nodosa | seizure; acute renal failure then intestinal bleeding | b.d | eclampsy; preterm and caesarean delivery | Fatal (autoptic diagnosis) |
Bassa et al. [59] | 1995 | South Africa | Takayasu arteritis | claudication of upper limbs; brachial and radial pulses weak or absent; decreased blood pressure of upper limb and ectacic and stenotic lesions of both carotid arteries | 4 m p.d | caesarean delivery | Favourable with: - corticosteroids |
Suzuki et al. [60] | 1990 | Japan | Leptomeningeal vessels vasculitis associated with Systemic Lupus erythomatosus | fever; headache, stiffneck; seizure; oculomotor nerve palsy; ataxia; paraplegia; respiratory arrest and autoptic findings of necrotizing vasculitis of small vessels of heart, liver, pancreas, gall and urinary bladders | 11 d b.d | eclampsy; preterm and caesarean delivery | Fatal (autoptic diagnosis) |
This case | 2022 | France | Granulomatosis with Polyangiitis | musculoskeletal pain involving knees, ankles, wrists and shoulders; bilateral conjunctivitis; purpuric eruption of lower limbs; aphtae; proteinuria and bilateral cavitary lung lesions | 2 w p.d | gestational diabetes | Favourable with: - corticosteroids - rituximab |