View More View Less
  • 1 Országos Reumatológiai és Fizioterápiás Intézet Budapest Frankel Leó út 38–40. 1023
  • | 2 Semmelweis Egyetem, Általános Orvostudományi Kar III. Belgyógyászati Klinika, II. Reumatológiai Tanszéki Csoport Budapest
  • | 3 Veszprém Megyei Csolnoky Ferenc Kórház Nonprofit Zrt. Veszprém
Open access

A szisztémás autoimmun betegségek és a terhesség együttes jelentkezése a háttérben zajló immunológiai és hormonális tényezők egymásra hatása következtében megváltoztatja mind az autoimmun kórkép, mind a terhesség lefolyását. Mivel az autoimmun betegek többnyire nők, sokszor fiatalok, fogamzóképes korban vannak és gyereket szeretnének, egyre inkább fel kell készülnünk erre a speciális helyzetre. Az elmúlt 30 évben jelentősen változott e betegek gyerekvállalásának a megítélése. Míg korábban szisztémás lupus erythematosusban a terhesség alatt és után akár 50%-ban is fellángolt a betegség, ez az arány az elmúlt időszakban jelentősen csökkent. Sokkal nagyobb gondot fordítunk arra, hogy a betegség a fogamzáskor ne mutasson aktivitást, ilyen esetben legalább felére csökken a betegség fellángolásának veszélye. A jobb eredményekhez hozzájárul a gondosabb betegvezetés, a kortikoszteroid megfontoltabb használata is. Antifoszfolipid-szindrómában adekvát antithromboticus kezelés hatására szignifikáns mértékben javult a sikeresen kiviselt terhességek aránya. Rheumatoid arthritisben a methotrexat bátrabb használata, a tumornekrózis-faktor-alfa-gátlók alkalmazása megváltoztatta a betegség természetes lefolyását, egyre több beteg kerül remisszióba. Ez közvetett módon a terhesség vállalását, kiviselését is kedvezően befolyásolja. Jelen tanulmányban a szerzők áttekintik a gyakoribb szisztémás autoimmun betegségek és a terhesség kapcsolatát, valamint a terhesség alatt alkalmazható gyógyszeres kezelés lehetőségeit. Orv. Hetil., 2011, 152, 1715–1723.

  • Pennesi, G., Brioli, G., Lulli, P. és mtsai: HLA and complement factors alleles sharing in Italian couples with recurrent spontaneous abortions. Human Immunol., 1998, 59, 382–386.

    Lulli P. , 'HLA and complement factors alleles sharing in Italian couples with recurrent spontaneous abortions ' (1998 ) 59 Human Immunol. : 382 -386.

    • Search Google Scholar
  • Szekeres Barthó J.: A reprodukciós rendszer immunológiai betegségei. In: Klinikai Imunológia. Szerk.: Petrányi Gy. Medicina Könyvkiadó, Budapest, 2000, 662–675.

    Szekeres Barthó J. , '', in Klinikai Imunológia , (2000 ) -.

  • King, A., Loke, Y. W., Chaouat, G.: NK cells and reproduction. Immunol. Today, 1997, 18, 64–66.

    Chaouat G. , 'NK cells and reproduction ' (1997 ) 18 Immunol. Today : 64 -66.

  • Raghupathy, R.: Th1-type immunity is incompatible with successful pregnancy. Immunol. Today, 1997, 18, 478–482.

    Raghupathy R. , 'Th1-type immunity is incompatible with successful pregnancy ' (1997 ) 18 Immunol. Today : 478 -482.

    • Search Google Scholar
  • Ostensen, M., Brucato, A., Carp, H. és mtsai: Pregnancy and reproduction in autoimmune rheumatic diseases. Rheumatology (Oxford), 2011, 50, 657–664.

    Carp H. , 'Pregnancy and reproduction in autoimmune rheumatic diseases ' (2011 ) 50 Rheumatology (Oxford) : 657 -664.

    • Search Google Scholar
  • Kiss E.: Szisztémás lupus erythematosus. In: A belgyógyászat alapjai. II. kötet. Szerk.: Tulassay Zs. Medicina Könyvkiadó, Budapest, 2007, 1196–1204.

    Kiss E. , '', in A belgyógyászat alapjai. II. kötet , (2007 ) -.

  • Kiss E.: Szisztémás lupus erythematosus. In: A reumatológia tankönyve. Szerk.: Poór Gy. Medicina Könyvkiadó, Budapest, 2008, 156–163.

    Kiss E. , '', in A reumatológia tankönyve , (2008 ) -.

  • Hochberg, M.: Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum., 1997, 40, 1725–1743.

    Hochberg M. , 'Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus ' (1997 ) 40 Arthritis Rheum. : 1725 -1743.

    • Search Google Scholar
  • Kiss E., Zeher M., Szegedi Gy.: A szisztémás lupus erythematosus diagnosztikája és klasszifikációja. Magyar Immunol., 2002, 1, 38–40.

    Szegedi Gy. , 'A szisztémás lupus erythematosus diagnosztikája és klasszifikációja ' (2002 ) 1 Magyar Immunol. : 38 -40.

    • Search Google Scholar
  • Tarr, T., Lakos, G., Bhattoa, H. P. és mtsai: Clinical thrombotic manifestations in SLE patients with and without antiphospholipid antibodies: a 5-year follow-up. Clin. Rev. Allergy Immunol., 2007, 32, 131–137.

    Bhattoa H. P. , 'Clinical thrombotic manifestations in SLE patients with and without antiphospholipid antibodies: a 5-year follow-up ' (2007 ) 32 Clin. Rev. Allergy Immunol. : 131 -137.

    • Search Google Scholar
  • Kanda, N., Tsuchida, T., Tamaki, K.: Estrogen enhancement of anti-double-stranded DNA antibody and immunoglobulin G production in peripheral blood mononuclear cells from patients with systemic lupus erythematosus. Arthritis Rheum., 1999, 42, 328–337.

    Tamaki K. , 'Estrogen enhancement of anti-double-stranded DNA antibody and immunoglobulin G production in peripheral blood mononuclear cells from patients with systemic lupus erythematosus ' (1999 ) 42 Arthritis Rheum. : 328 -337.

    • Search Google Scholar
  • Buyon, J. P., Petri, M. A., Kim, M. Y. és mtsai: The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial. Ann. Intern. Med., 2005, 142, 953–962.

    Kim M. Y. , 'The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial ' (2005 ) 142 Ann. Intern. Med. : 953 -962.

    • Search Google Scholar
  • Bhattoa, H. P., Bettembuk, P., Balogh, A. és mtsai: The effect of 1-year transdermal estrogen replacement therapy on bone mineral density and biochemical markers of bone turnover in osteopenic postmenopausal systemic lupus erythematosus patients: a randomized, double-blind placebo-controlled trial. Osteoporosis Int., 2004, 15, 396–404.

    Balogh A. , 'The effect of 1-year transdermal estrogen replacement therapy on bone mineral density and biochemical markers of bone turnover in osteopenic postmenopausal systemic lupus erythematosus patients: a randomized, double-blind placebo-controlled trial ' (2004 ) 15 Osteoporosis Int. : 396 -404.

    • Search Google Scholar
  • Barry, N. N., McGuire, J. L., van Vollenhoven, R. F.: Dehydroepiandrosterne in systemic lupus erythematosus: relationship between dosage, serum levels, and clinical response. J. Rheumatol., 1998, 25, 2352–2356.

    Vollenhoven R. F. , 'Dehydroepiandrosterne in systemic lupus erythematosus: relationship between dosage, serum levels, and clinical response ' (1998 ) 25 J. Rheumatol. : 2352 -2356.

    • Search Google Scholar
  • Bernier, M. O., Mikaeloff, Y., Hudson, M. és mtsa: Combined oral contraceptive use and the risk of systemic lupus erythematous. Arthritis Rheum., 2009, 61, 476–481.

    Hudson M. , 'Combined oral contraceptive use and the risk of systemic lupus erythematous ' (2009 ) 61 Arthritis Rheum. : 476 -481.

    • Search Google Scholar
  • Sanches-Guerrero, J., Karlson, E. W., Liang, M. H. és mtsai: Past use of oral contraceptives and the risk of developing systemic lupus erythematosus. Arthritis Rheum., 1997, 40, 804–808.

    Liang M. H. , 'Past use of oral contraceptives and the risk of developing systemic lupus erythematosus ' (1997 ) 40 Arthritis Rheum. : 804 -808.

    • Search Google Scholar
  • Petri, M., Kim, M. Y., Kalunian, K. C. és mtsai: OC-SELENA Trial.: Combined oral contraceptives in women with systemic lupus erythematosus. N. Engl. J. Med., 2005, 353, 2550–2558.

    Kalunian K. C. , 'OC-SELENA Trial.: Combined oral contraceptives in women with systemic lupus erythematosus ' (2005 ) 353 N. Engl. J. Med. : 2550 -2558.

    • Search Google Scholar
  • Buyon, J. P.: Oral contraceptives in women with systemic lupus erythematsus. Ann. Med. Interne (Paris), 1996, 147, 259–264.

    Buyon J. P. , 'Oral contraceptives in women with systemic lupus erythematsus ' (1996 ) 147 Ann. Med. Interne (Paris) : 259 -264.

    • Search Google Scholar
  • Julkunen, H. A.: Oral contraceptives in systemic lupus erythematosus: side-effects and influence on the activity of SLE. Scand J. Rheumatol., 1991, 20, 427–433.

    Julkunen H. A. , 'Oral contraceptives in systemic lupus erythematosus: side-effects and influence on the activity of SLE ' (1991 ) 20 Scand J. Rheumatol. : 427 -433.

    • Search Google Scholar
  • Julkunen, H. A., Kaaja, R., Friman, C.: Contraceptive practice in women with systemic lupus erythematosus. Br. J. Rheumatol., 1993, 32, 227–230.

    Friman C. , 'Contraceptive practice in women with systemic lupus erythematosus ' (1993 ) 32 Br. J. Rheumatol. : 227 -230.

    • Search Google Scholar
  • Vad, S., Lakos, G., Kiss, E. és mtsai: Antiphospholipid antibodies in young women with and without oral contraceptive use. Blood Coagul. Fibrinolysis, 2003, 14, 57–60.

    Kiss E. , 'Antiphospholipid antibodies in young women with and without oral contraceptive use ' (2003 ) 14 Blood Coagul. Fibrinolysis : 57 -60.

    • Search Google Scholar
  • Culwell, K. R., Curtis, K. M., del Carmen Cravioto, M.: Safety of contraceptive method use among women with systemic lupus erythematosus: a systematic review. Obstet. Gynecol., 2009, 114, 341–353.

    Carmen Cravioto M. , 'Safety of contraceptive method use among women with systemic lupus erythematosus: a systematic review ' (2009 ) 114 Obstet. Gynecol. : 341 -353.

    • Search Google Scholar
  • Kiss E., Szegedi Gy.: Systemas lupus erythematosusos betegeink terhességeinek elemzése. Allergol. Klin. Immunol., 1998, 4, 190–197.

    Szegedi Gy. , 'Systemas lupus erythematosusos betegeink terhességeinek elemzése ' (1998 ) 4 Allergol. Klin. Immunol. : 190 -197.

    • Search Google Scholar
  • Ruiz-Irastorza, G., Khamashta, M. A.: Lupus and pregnancy: ten questions and some answers. Lupus, 2008, 17, 416–420.

    Khamashta M. A. , 'Lupus and pregnancy: ten questions and some answers ' (2008 ) 17 Lupus : 416 -420.

    • Search Google Scholar
  • Petri, M.: The Hopkins Lupus Pregnancy Center: ten key issues in the management. Rheum. Dis. Clin. North Am., 2007, 33, 227–235.

    Petri M. , 'The Hopkins Lupus Pregnancy Center: ten key issues in the management ' (2007 ) 33 Rheum. Dis. Clin. North Am. : 227 -235.

    • Search Google Scholar
  • Tandon, A., Ibanez, D., Gladman, D. D. és mtsa: The effect of pregnancy on lupus nephritis. Arthritis Rheum., 2004, 50, 3941–3946.

    Gladman D. D. , 'The effect of pregnancy on lupus nephritis ' (2004 ) 50 Arthritis Rheum. : 3941 -3946.

    • Search Google Scholar
  • Rahman, P., Gladman, D. D., Urowitz, M. B.: Clinical predictors of fetal outcome in systemic lupus erythematosus. J. Rheumatol., 1998, 25, 1526–1530.

    Urowitz M. B. , 'Clinical predictors of fetal outcome in systemic lupus erythematosus ' (1998 ) 25 J. Rheumatol. : 1526 -1530.

    • Search Google Scholar
  • Salmon, J., Kim, M. A., Rana, S.: Angiogenic factor imbalance in pregnant SLE patients may explain increased risk for complications. Arthritis Rheum., 2009, 60, s655.

    Rana S. , 'Angiogenic factor imbalance in pregnant SLE patients may explain increased risk for complications ' (2009 ) 60 Arthritis Rheum. : s655 -.

    • Search Google Scholar
  • Steen, V. D.: Pregnancy in scleroderma. Rheum. Dis. Clin. North Am., 2007, 33, 345–358.

    Steen V. D. , 'Pregnancy in scleroderma ' (2007 ) 33 Rheum. Dis. Clin. North Am. : 345 -358.

  • Clowse, M. E. B., Magder, L. S., Petri, M.: The clinical utility of measuring complement and anti-dsDNA antibodies during pregnancy in patients with systemic lupus erythematosus. J. Rheumatol., 2011, 38, 1012–1016.

    Petri M. , 'The clinical utility of measuring complement and anti-dsDNA antibodies during pregnancy in patients with systemic lupus erythematosus ' (2011 ) 38 J. Rheumatol. : 1012 -1016.

    • Search Google Scholar
  • Kiss, E., Bhattoa, H. P., Bettembuk, P. és mtsai: Pregnancy in women with systemic lupus erythematosus. Eur. J. Obstet. Gynecol. Reprod. Biol., 2002, 101, 129–134.

    Bettembuk P. , 'Pregnancy in women with systemic lupus erythematosus ' (2002 ) 101 Eur. J. Obstet. Gynecol. Reprod. Biol. : 129 -134.

    • Search Google Scholar
  • Tarr, T., Lakos, G., Bhattoa, H. P. és mtsai: Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients. Lupus, 2007, 16, 39–45.

    Bhattoa H. P. , 'Analysis of risk factors for the development of thrombotic complications in antiphospholipid antibody positive lupus patients ' (2007 ) 16 Lupus : 39 -45.

    • Search Google Scholar
  • Miyakis, S., Lockshin, M. D., Atsumi, T. és mtsai: International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J. Thromb. Haemost., 2006, 4, 295–306.

    Atsumi T. , 'International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS) ' (2006 ) 4 J. Thromb. Haemost. : 295 -306.

    • Search Google Scholar
  • Sebire, N. J., Backos, M., El Gaddal, S. és mtsai: Placental pathology, antiphospholipid antibodies, and pregnancy outcome in recurrent miscarriage patients. Obstet. Gynecol., 2003, 101, 253–263.

    Gaddal S. , 'Placental pathology, antiphospholipid antibodies, and pregnancy outcome in recurrent miscarriage patients ' (2003 ) 101 Obstet. Gynecol. : 253 -263.

    • Search Google Scholar
  • Tincani, A., Cavazzana, I., Ziglioli, T. és mtsai: Complement activation and pregnancy failure. Clin. Rev. Allergol. Immunol., 2010, 39, 153–159.

    Ziglioli T. , 'Complement activation and pregnancy failure ' (2010 ) 39 Clin. Rev. Allergol. Immunol. : 153 -159.

    • Search Google Scholar
  • Rotar, Z., Rozman, B., de Grooth, P. G. és mtsai: Sixth meeting of the European Forum on antiphospholipid antibodies. How to improve the understanding of the antiphospholipid syndrome? Lupus, 2009, 18, 53–60.

    Grooth P. G. , 'Sixth meeting of the European Forum on antiphospholipid antibodies. How to improve the understanding of the antiphospholipid syndrome? ' (2009 ) 18 Lupus : 53 -60.

    • Search Google Scholar
  • Dadhwal, V., Sharma, A. K., Deka, D. és mtsai: The obstetric outcome following treatment in a cohort of patients with antiphospholipid antibody syndrome in a tertiary care center. J. Postgrad. Med., 2011, 57, 16–19.

    Deka D. , 'The obstetric outcome following treatment in a cohort of patients with antiphospholipid antibody syndrome in a tertiary care center ' (2011 ) 57 J. Postgrad. Med. : 16 -19.

    • Search Google Scholar
  • Kiss, E., Soltesz, P., Der, H. és mtsai: Reduced flow-mediated vasodilation as a marker for cardiovascular complications in lupus patients. J. Autoimmun., 2006, 27, 211–217.

    Der H. , 'Reduced flow-mediated vasodilation as a marker for cardiovascular complications in lupus patients ' (2006 ) 27 J. Autoimmun. : 211 -217.

    • Search Google Scholar
  • Foidart, M., Schaaps, J. P., Chantraine, F. és mtsai: Dysregulation of anti-angiogenic agents (sFlt-1, PLGF, and sEndoglin) in preeclampsia – a step forward but not the definitive answer. J. Reprod. Immunol., 2009, 82, 106–111.

    Chantraine F. , 'Dysregulation of anti-angiogenic agents (sFlt-1, PLGF, and sEndoglin) in preeclampsia – a step forward but not the definitive answer ' (2009 ) 82 J. Reprod. Immunol. : 106 -111.

    • Search Google Scholar
  • Lampé, R., Szucs, S., Adány, R. és mtsa: Granulocyte superoxide anion production and regulation by plasma factors in normal and preeclamptic pregnancy. J. Reprod. Immunol., 2011, 89, 199–206.

    Adány R. , 'Granulocyte superoxide anion production and regulation by plasma factors in normal and preeclamptic pregnancy ' (2011 ) 89 J. Reprod. Immunol. : 199 -206.

    • Search Google Scholar
  • Erkan, D., Patel, S., Nuzzo, M. és mtsai: Management of the controversial aspects of the antiphospholipid syndrome pregnancies: a guide for clinicians and researchers. Rheumatology, 2008, 47, (Suppl. 3), iii23–iii27.

    Nuzzo M. , 'Management of the controversial aspects of the antiphospholipid syndrome pregnancies: a guide for clinicians and researchers ' (2008 ) 47 Rheumatology : iii23 -iii27.

    • Search Google Scholar
  • Giannakopoulos, B., Krilis, S. A.: How to treat the antiphospholipid sydrome? Blood, 2009, 114, 2020–2030.

    Krilis S. A. , 'How to treat the antiphospholipid sydrome? ' (2009 ) 114 Blood : 2020 -2030.

  • Neri, F., Chimini., L., Bonomi, F. és mtsai: Neuropsychological development of children born to patients with systemic lupus erythematosus. Lupus, 2004, 13, 805–811.

    Bonomi F. , 'Neuropsychological development of children born to patients with systemic lupus erythematosus ' (2004 ) 13 Lupus : 805 -811.

    • Search Google Scholar
  • Bucato, A., Doria, A., Frassi, M. és mtsai: Pregnancy outcome is 100 women with autoimmune diseases and anti-Ro/SS-A antibodies: a prospective controlled study. Lupus, 2002, 11, 716–721.

    Frassi M. , 'Pregnancy outcome is 100 women with autoimmune diseases and anti-Ro/SS-A antibodies: a prospective controlled study ' (2002 ) 11 Lupus : 716 -721.

    • Search Google Scholar
  • Kiss E.: Szubakut cutan lupus erythematosus (SCLE). In: Betegség enciklopédia. Szerk.: Kornya L. Springer Kiadó, Budapest, 2002, 1101–1102.

    Kiss E. , '', in Betegség enciklopédia , (2002 ) -.

  • Kiss E.: Sjögren-szindróma. In: A reumatológia tankönyve. Szerk.: Poór Gy. Medicina Könyvkiadó, Budapest, 2008, 168–170.

    Kiss E. , '', in A reumatológia tankönyve , (2008 ) -.

  • Gutiérrez, G., Dagnino, R., Mintz, G.: Polymyositis/dermatomyositis and pregnancy. Arthritis Rheum., 1984, 27, 291–294.

    Mintz G. , 'Polymyositis/dermatomyositis and pregnancy ' (1984 ) 27 Arthritis Rheum. : 291 -294.

    • Search Google Scholar
  • Váncsa, A., Ponyi, A., Constantin, T. és mtsai: Pregnancy outcome in idiopathic inflammatory myopathy. Rheumatol. Int., 2007, 27, 435–439.

    Constantin T. , 'Pregnancy outcome in idiopathic inflammatory myopathy ' (2007 ) 27 Rheumatol. Int. : 435 -439.

    • Search Google Scholar
  • Chakravarty, E. F.: Vascular complications of systemic sclerosis during pregnancy.; Int. J. Rheumatol., 2010, 2010. pii: 287248. Epub. 2010 Aug 11.

  • Sharma, P., Sharma, S., Baltaro, R. és mtsa: Systemic vasculitis. Am. Fam. Physician, 2011, 83, 556–565.

    Baltaro R. , 'Systemic vasculitis ' (2011 ) 83 Am. Fam. Physician : 556 -565.

  • Pagnoux, C., Le Guern, V., Goffinet, F. és mtsai: Pregnancies in systemic necrotizing vasculitides: report on 12 women and their 20 pregnancies. Rheumatology (Oxford), 2011, 50, 953–961.

    Goffinet F. , 'Pregnancies in systemic necrotizing vasculitides: report on 12 women and their 20 pregnancies ' (2011 ) 50 Rheumatology (Oxford) : 953 -961.

    • Search Google Scholar
  • Kiss, C. G., Lövei, C., Sütö, G. és mtsai: Prevalence of rheumatoid arthritis in the South-Transdanubian region of Hungary based on a representative survey of 10,000 inhabitants. J. Rheumatol., 2005, 32, 1688–1690.

    Sütö G. , 'Prevalence of rheumatoid arthritis in the South-Transdanubian region of Hungary based on a representative survey of 10,000 inhabitants ' (2005 ) 32 J. Rheumatol. : 1688 -1690.

    • Search Google Scholar
  • Persellin, R. H.: The effect of pregnancy on rheumatoid arthritis. Bull. Rheum. Dis., 1976–1977, 27, 922–927.

    Persellin R. H. , 'The effect of pregnancy on rheumatoid arthritis ' (1976 ) 27 Bull. Rheum. Dis. : 922 -927.

    • Search Google Scholar
  • Drossaers-Bakker, K. W., Zwinderman, A. H., van Zeben, D. és mtsai: Pregnancy and oral contraceptive use do not significantly influence outcome in long term rheumatoid arthritis. Ann. Rheum. Dis., 2002, 61, 405–408.

    Zeben D. , 'Pregnancy and oral contraceptive use do not significantly influence outcome in long term rheumatoid arthritis ' (2002 ) 61 Ann. Rheum. Dis. : 405 -408.

    • Search Google Scholar
  • Masi, A. T.: Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? Clin. Exp. Rheumatol., 1995, 13, 227–240.

    Masi A. T. , 'Sex hormones and rheumatoid arthritis: cause or effect relationships in a complex pathophysiology? ' (1995 ) 13 Clin. Exp. Rheumatol. : 227 -240.

    • Search Google Scholar
  • Liang, M. H., Karlson, E. W.: Female hormone therapy and the risk of developing or exacerbating systemic lupus erythematosus or rheumatoid arthritis. Proc. Assoc. Am. Physicians, 1996, 108, 25–28.

    Karlson E. W. , 'Female hormone therapy and the risk of developing or exacerbating systemic lupus erythematosus or rheumatoid arthritis ' (1996 ) 108 Proc. Assoc. Am. Physicians : 25 -28.

    • Search Google Scholar
  • Oliver, J. E., Silman, A. J.: Risk factors for the development of rheumatoid arthritis. Scand. J. Rheumatol., 2006, 35, 169–174.

    Silman A. J. , 'Risk factors for the development of rheumatoid arthritis ' (2006 ) 35 Scand. J. Rheumatol. : 169 -174.

    • Search Google Scholar
  • Nelson, J. L., Ostensen, M.: Pregnancy and rheumatoid arthritis. Rheum. Dis. Clin. North Am., 1997, 23, 195–212.

    Ostensen M. , 'Pregnancy and rheumatoid arthritis ' (1997 ) 23 Rheum. Dis. Clin. North Am. : 195 -212.

    • Search Google Scholar
  • Kass, A. S., Lea, T. E., Torjesen, P. A. és mtsai: The association of luteinizing hormone and follicle-stimulating hormone with cytokines and markers of disease activity in rheumatoid arthritis: a case–control study. Scand. J. Rheumatol., 2010, 39, 109–117.

    Torjesen P. A. , 'The association of luteinizing hormone and follicle-stimulating hormone with cytokines and markers of disease activity in rheumatoid arthritis: a case–control study ' (2010 ) 39 Scand. J. Rheumatol. : 109 -117.

    • Search Google Scholar
  • Guthrie, K. A., Dugowson, C. E., Voigt, L. F. és mtsai: Does pregnancy provide vaccine-like protection against rheumatoid arthritis? Arthritis Rheum., 2010, 62, 1842–1848.

    Voigt L. F. , 'Does pregnancy provide vaccine-like protection against rheumatoid arthritis? ' (2010 ) 62 Arthritis Rheum. : 1842 -1848.

    • Search Google Scholar
  • Van de Geijn, F. E., Wuhrer, M., Selman, M. H. és mtsai: Immunoglobulin G galactosylation and sialylation are associated with pregnancy-induced improvement of rheumatoid arthritis and the postpartum flare: results from a large prospective cohort study. Arthritis Res. Ther., 2009, 11, R193.

    Selman M. H. , 'Immunoglobulin G galactosylation and sialylation are associated with pregnancy-induced improvement of rheumatoid arthritis and the postpartum flare: results from a large prospective cohort study ' (2009 ) 11 Arthritis Res. Ther. : R193 -.

    • Search Google Scholar
  • Yan, Z., Aydelotte, T., Gadi, V. K. és mtsai: Acquisition of the rheumatoid arthritis HLA shared epitope through microchimerism. Arthritis Rheum., 2011, 63, 640–644.

    Gadi V. K. , 'Acquisition of the rheumatoid arthritis HLA shared epitope through microchimerism ' (2011 ) 63 Arthritis Rheum. : 640 -644.

    • Search Google Scholar
  • Rank, J. M., Maestroni, L., Balandraud, N. és mtsai: Transfer of the shared epitope through microchimerism in women with rheumatoid arthriris. Arthritis Rheum., 2009, 60, 73–80.

    Balandraud N. , 'Transfer of the shared epitope through microchimerism in women with rheumatoid arthriris ' (2009 ) 60 Arthritis Rheum. : 73 -80.

    • Search Google Scholar
  • Galeazzi, M., Morozzi, G., Piccini, M. és mtsai: Dosage and characterization of circulating DNA: present usage and possible application in systemic autoimmune disorders. Autoimmun. Rev., 2003, 2, 50–55.

    Piccini M. , 'Dosage and characterization of circulating DNA: present usage and possible application in systemic autoimmune disorders ' (2003 ) 2 Autoimmun. Rev. : 50 -55.

    • Search Google Scholar
  • De Man, Y. A., Dolhain, R. J., van de Geijn, F. E. és mtsai: Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. Arthritis Rheum., 2008, 59, 1241–1248.

    Geijn F. E. , 'Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study ' (2008 ) 59 Arthritis Rheum. : 1241 -1248.

    • Search Google Scholar
  • De Man, Y. A., Hazes, J. M., van der Heide, H. és mtsai: Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum., 2009, 60, 3196–3206.

    Heide H. , 'Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study ' (2009 ) 60 Arthritis Rheum. : 3196 -3206.

    • Search Google Scholar
  • Hazes, J. M., Man, de Y. A.: Pregnancy. In: Oxford textbook of rheumatology. 3rd ed. Eds: Isenberg, D. A., Maddison, P. J., Woo, P., Glass, D., Breedveld, F. C. Oxford University Press, United States, 2004, 117–125.

    Man Y. A. , '', in Oxford textbook of rheumatology , (2004 ) -.

  • De Man, Y. A., Bakker-Jonges, L. E., Goorbergh, C. M. és mtsai: Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy. Ann. Rheum. Dis., 2010, 69, 420–423.

    Goorbergh C. M. , 'Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy ' (2010 ) 69 Ann. Rheum. Dis. : 420 -423.

    • Search Google Scholar
  • Kaaja, R. J., Greer, I. A.: Manifestations of chronic disease during pregnancy. JAMA, 2005, 294, 2751–2757.

    Greer I. A. , 'Manifestations of chronic disease during pregnancy ' (2005 ) 294 JAMA : 2751 -2757.

    • Search Google Scholar
  • Matera, L., Mori, M., Geuna, M. és mtsai: Prolactin in autoimmunity and antitumor defence. J. Neuroimmunol., 2000, 109, 47–55.

    Geuna M. , 'Prolactin in autoimmunity and antitumor defence ' (2000 ) 109 J. Neuroimmunol. : 47 -55.

    • Search Google Scholar
  • Barrett, J. H., Brennan, P., Fiddler, M. és mtsa: Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. Arthritis. Rheum., 2000, 43, 1010–1015.

    Fiddler M. , 'Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis ' (2000 ) 43 Arthritis. Rheum. : 1010 -1015.

    • Search Google Scholar
  • Clowse, M. E.: Managing contraception and pregnancy in the rheumatologic diseases. Best Pract. Res. Clin. Rheumatol., 2010, 24, 373–385.

    Clowse M. E. , 'Managing contraception and pregnancy in the rheumatologic diseases ' (2010 ) 24 Best Pract. Res. Clin. Rheumatol. : 373 -385.

    • Search Google Scholar

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Jan 2021 0 1 83
Feb 2021 0 14 113
Mar 2021 0 6 121
Apr 2021 0 5 100
May 2021 0 5 41
Jun 2021 0 2 33
Jul 2021 0 0 0