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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Acute peripartum pancreatitis complicating seronegative antiphospholipid antibody syndrome in pregnancy
  1. Zoe Zimmer1,
  2. Rebecca Hill2,
  3. Victoria Fratto3 and
  4. Monica A Lutgendorf4
  1. 1 Gynecologic Surgery and Obstetrics, Naval Medical Center San Diego, San Diego, California, USA
  2. 2 Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
  3. 3 Maternal Fetal Medicine, Naval Medical Center San Diego, San Diego, California, USA
  4. 4 Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  1. Correspondence to Dr Zoe Zimmer; zoe.c.zimmer.mil{at}health.mil

Abstract

Antiphospholipid antibody syndrome is an autoimmune condition with clinical manifestations of vascular thrombosis and adverse pregnancy outcomes including recurrent miscarriage, fetal loss, growth restriction and pre-eclampsia with persistent antiphospholipid antibodies on laboratory examination. Treatment is targeted at preventing recurrent thrombosis and improving pregnancy outcomes. Commonly, treatment includes aspirin and anticoagulation, however, newer immunomodulatory treatments may also improve outcomes. The case describes a patient with a history of multiple miscarriages and pregnancy losses, fetal growth restriction and pre-eclampsia, and pulmonary embolism. Because of her significant adverse pregnancy outcomes, she was treated with certolizumab with a successful delivery at 33 weeks and 6 days. She also developed acute pancreatitis in the postpartum period. This is a rare condition, affecting 1–14/10 000 births. The pancreatitis resolved with conservative management, and she had an uncomplicated interval cholecystectomy.

  • Obstetrics, gynaecology and fertility
  • Pancreatitis
  • Pregnancy
  • Biological agents

https://doi.org/10.1136/bcr-2022-250664

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    Footnotes

    • Contributors ZZ contributed to the planning, literature review and drafting of the manuscript. RH contributed to literature review and secondary drafting of the work. VF and MAL contributed to planning and revision of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.