Pregnancy, Hormones and Uveitis

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Mike Bartolatz
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Pregnancy, Hormones and Uveitis

Post by Mike Bartolatz » Mon Nov 22, 2004 4:52 pm

A correlation of pregnancy term, disease activity, serum female hormones, and cytokines in uveitis.

Chan CC, Reed GF, Kim Y, Agron E, Buggage RR.

Bldg 10, Room 10N103, NIH/NEI, 10 Center Drive, Bethesda, MD 20892-1857, USA. chanc@nei.nih.gov.

BACKGROUND/AIMS: Pregnancy and the postpartum period are associated with the activity of autoimmune diseases including uveitis. Although the exact mechanism is unknown, hormones are reported to alter inflammatory cytokines and influence disease activity. The authors studied ocular inflammation, female hormones, and serum cytokine levels during and after pregnancy. METHODS: A prospective, observational case study was conducted. Four pregnant women in their first trimester with chronic non-infectious uveitis were followed monthly until 6 months after delivery. Serum female hormones (oestrogen, progesterone, prolactin) and various cytokines (IL-2, IL-4, IL-5, IL-6, IL-10, IFN-gamma, and TGF-beta) were measured by ELISA. RESULTS: The four patients had five full term pregnancies. Uveitis activity decreased after the first trimester but flared in the early postpartum period. Serum female hormones, highly elevated during pregnancy, drastically dropped post partum. Cytokine levels except TGF-beta were mostly undetectable. CONCLUSION: Female hormones and TGF-beta may contribute to the activity of uveitis during pregnancy and the postpartum period.

PMID: 15548800 [PubMed - as supplied by publisher]

________________________________________________________________________Noninfectious uveitis and pregnancy.

Rabiah PK, Vitale AT.

Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. prabiah@enh.org

PURPOSE: To report the course of uveitis disease activity during pregnancy and the postpartum period in women with noninfectious uveitis. DESIGN: Observational case series. METHODS: The medical records of women with noninfectious uveitis and pregnancy during follow-up at a large eye hospital were retrospectively reviewed. Patients with pregnancy were included in the study if follow-up was adequate to document the presence or absence of flare-ups in uveitis activity during the pregnancy and/or postpartum period. RESULTS: Seventy-six pregnancies among 50 women were included in the study. Thirty-three pregnancies were in women with Vogt-Koyanagi-Harada disease, 19 were in women with Behcet disease, and 24 were in women with idiopathic uveitis. A flare-up in uveitis activity occurred within the first 4 months of pregnancy in 49 of 76 cases (64%) and later in pregnancy in 17 cases (22%); no flare-up occurred during pregnancy in 21 cases (28%). An early pregnancy flare-up was typical of Vogt-Koyanagi-Harada disease and idiopathic uveitis. A flare-up within 6 months of delivery occurred in 38 of 59 cases (64%) that had adequate examination data available from the postpartum period. The postpartum flare-up was especially typical of Behcet disease. CONCLUSIONS: Many women with noninfectious uveitis will experience a flare-up in disease activity within the first 4 months of pregnancy. Later pregnancy appears to be a time of relative disease inactivity. Many will experience a rebound in activity within 6 months of delivery.

PMID: 12834675 [PubMed - indexed for MEDLINE]
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