Document Detail

Glucocorticosteroids in pregnant patients with rheumatoid arthritis.
MedLine Citation:
PMID:  11155808     Owner:  NLM     Status:  MEDLINE    
The ameliorating effect of pregnancy on rheumatoid arthritis (RA) has been well known since 1938 and repeatedly confirmed for 75% of RA pregnancies. Improvement of symptoms usually occurs already in the first trimester and increases as pregnancy progresses. A flare of RA is observed within 6 months after delivery in most patients. Originally believed to be due to the increase of cortisol during pregnancy, three studies of the 1950-60s did not find a correlation between cortisol levels and disease activity in pregnant patients. Also the timing of gestational improvement and the postpartum flare does not coincide with the rise and fall of cortisol levels. New research has disclosed neuroendocrine disturbances in RA including a relative glucocorticoid deficiency. The complex hormonal and immunological alterations of pregnancy may temporarily correct the neuroendocrine defects. The precise role of glucocorticoids in pregnancy-induced remission of RA still needs to be clarified.
M Ostensen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Zeitschrift für Rheumatologie     Volume:  59 Suppl 2     ISSN:  0340-1855     ISO Abbreviation:  Z Rheumatol     Publication Date:  2000  
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-04-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0414162     Medline TA:  Z Rheumatol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  II/70-4     Citation Subset:  IM    
Clinic for Rheumatology and Clinical Immunology, University Hospital of Berne, CH-3010 Bern, Switzerland.
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MeSH Terms
Arthritis, Rheumatoid / physiopathology*
Glucocorticoids / physiology*
Hydrocortisone / blood
Infant, Newborn
Neurosecretory Systems / physiopathology
Postpartum Period / physiology
Pregnancy Complications / physiopathology*
Remission, Spontaneous
Reg. No./Substance:
0/Glucocorticoids; 50-23-7/Hydrocortisone

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