This is a 27-year-old female patient with juvenile arthritis of 12 years of evolution affecting the knees, right ankle and 1st right MTCF. In the study she was HLA B-27 positive, ANAS negative and RF negative. There was no axial or extra-articular involvement. In treatment with medium-high doses of corticoids, 10-30 mg/day of prednisone with incomplete response, after no response to salazopyrin, methotrexate, hydroxychloroquine and corticoids at low doses, as well as infiltrations in both knees and ankle with corticoids and isotopic synoviorthesis of both knees with Yttrium-90.
After proposing treatment with etanercept, the patient was started at full doses accepted for juvenile arthritis, rheumatoid arthritis and ankylopoietic spondylitis, with a complete and sustained response.
In view of the desire to become a mother reported by the patient and her husband, we indicated the lack of experience with this type of drug and advised against pregnancy. In December 2005, after 3 years of asymptomatic treatment without requiring NSAIDs or corticosteroids, she came for consultation because she was two weeks pregnant (last menstrual period 26/11/2005) and so, in agreement with the patient, we withdrew etanercept and started treatment with prednisone in the event of a flare-up. Two weeks later, the patient came to the clinic reporting an incapacitating oligoarticular flare-up, for which she started treatment with etanercept, at a dose of 25 mg twice a week. We again pointed out the lack of experience and, in agreement with the patient, her husband and the health authorities, we continued the treatment with strict monitoring. We added ASA 50 mg/day, iron and folic acid to the treatment.
The due date is 23/08/2006. The pregnancy passed without complications and without arthritis activity, with anaemia and maintained elevation of acute phase reactants, which were completely normalised after delivery, which took place without complications, with a normal term newborn. Artificial lactation is advised and accepted. Treatment with etanercept is maintained in the pre and postpartum period, and the patient is asymptomatic and has normal blood tests with no inflammatory data or anaemia.
No malformations or medical problems were detected in the child at 13 months of follow-up.

