Successful Pregnancy Outcome in a Patient with Juvenile Idiopathic Arthritis in Adulthood, Amyloid A Amyloidosis, and Chronic Kidney Disease Using Tocilizumab with Strict Blood Pressure Control

Intern Med. 2024 May 1;63(9):1311-1316. doi: 10.2169/internalmedicine.1951-23. Epub 2023 Sep 29.

Abstract

Pregnancies with chronic kidney disease (CKD) and high disease activity in rheumatic diseases are high-risk events with adverse outcomes for both the mother and fetus. We herein report a 35-year-old woman with juvenile idiopathic arthritis (JIA), amyloid A (AA) amyloidosis related to JIA, and CKD stage G4A2 who wished to have children. She achieved a successful pregnancy, even in the presence of these multiple risk factors, using tocilizumab to control the disease activity of JIA and AA amyloidosis, along with antihypertensive drugs to control her blood pressure before and during pregnancy.

Keywords: Juvenile idiopathic arthritis; amyloid A amyloidosis; chronic kidney disease; pregnancy; rheumatic diseases; tocilizumab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amyloidosis* / complications
  • Amyloidosis* / drug therapy
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Arthritis, Juvenile* / complications
  • Arthritis, Juvenile* / drug therapy
  • Blood Pressure / drug effects
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Pregnancy Outcome
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / drug therapy
  • Serum Amyloid A Protein / metabolism

Substances

  • tocilizumab
  • Antibodies, Monoclonal, Humanized
  • Antihypertensive Agents
  • Serum Amyloid A Protein

Supplementary concepts

  • AA amyloidosis