This is a 27-year-old patient with juvenile arthritis of 12 years of evolution that affects the knees, right ankle and 1st right MCP.
The study showed positive HLA B-27, negative ANAS and negative RF.
There is no axial or extraarticular involvement.
In treatment with medium-high doses of corticoids, 10-30 mg/day of prednisone with incomplete response, after no response to salazopyrine, methotrexate, hydroxychloroquine and corticoids with low doses ankles 90,
After proposing treatment with etanercept to the patient, it starts at full doses accepted for juvenile arthritis, rheumatoid arthritis and ankylopoietic spondylitis, with complete and sustained response.
The desire to be a mother reported by the patient and her husband indicates the little experience with this type of drugs and advise against pregnancy.
In December 2005, after 3 years without symptoms requiring NSAIDs or corticoids, she came to the clinic for being pregnant for two weeks (last rule date 26/11/2005), so that, according to the patient, etanercept was withdrawn.
Two weeks later, the patient came to the clinic complaining of disabling oligoarticular sprout, so she was started on etanercept at a dose of 25 mg twice a week.
We again indicate the lack of experience and according to the patient, husband and health authorities, we maintain the treatment with strict follow-up.
We added ASA treatment 50 mg/day, iron and folic acid.
The expected date of delivery is August 23, 2006.
Pregnancy occurs without complications and without arthritis activity, with anemia and sustained elevation of acute phase reactants, which completely normalize after delivery, which occurs without complications, with a normal term newborn.
Artificial breastfeeding is advised and accepted.
Treatment is maintained in the pre-partum and postpartum period with etanercept being asymptomatic and with normal analytical results without inflammatory data or anemia.
No malformations or medical problems were detected in the child at 13 months of follow-up.
