Granulomatosis with polyangiitis and pregnancy: A case report and review of the literature

Abstract

The association of granulomatosis with polyangiitis and pregnancy is rare and therapeutic options are limited by the risk of teratogenicity and fetotoxicity. There is a paucity of published literature to guide clinical decision-making in these cases. We report the case of a 26-year-old woman with no medical history who presented at 21 weeks of gestation with a bilateral sudden loss of hearing and erosive rhinitis. The diagnosis of granulomatosis with polyangiitis was confirmed radiologically and biologically. Corticosteroids were not enough to stabilize the disease and she received intravenous immunoglobulins with remission. A successful delivery of a healthy male newborn was done at 36 weeks. A review of all published literature on granulomatosis with polyangiitis in pregnancy between 1970 and 2017 is presented. Trial registration: Not applicable.

Keywords: ANCA-associated vasculitis; Granulomatosis with polyangiitis; Wegener’s granulomatosis.

Figure 1.

Thoracic computed tomography showing multiple bilateral nodular cavitating lesions.

Figure 2.

Summary of all published case reports in literature according to disease activity during pregnancy. AZA: azathioprine; CYC: cyclophosphamide; IVIg: intravenous immunoglobulin; RTX: rituximab.