Adult-onset Still's disease (AOSD) is a rare inflammatory disease of unknown etiology that can present for the first time during pregnancy. Pure red cell aplasia (PRCA) is another rare condition that seldom is in association with AOSD. Herein, we have reported a newly diagnosed case with AOSD and PRCA in a previously healthy pregnant woman.
A 25-year-old primigravida lady presented with fever, malaise, and arthralgia at 26 weeks of gestation. She had an extensive evaluation that led to the diagnosis of AOSD. Preliminary blood tests displayed a severe anemia with hemoglobin 5.1 g/dL, leukocytosis (total white blood cells count of 26,000 μL(-1)), normal mean corpuscular volume, normal mean corpuscular hemoglobin, normal platelet count, and a low reticulocyte count (0.2 %). The condition was diagnosed as AOSD associated with PRCA. She was treated with prednisolone and had immediate and dramatic improvement.
AOSD and PRCA in pregnancy are rare conditions. The recognition of these clinical syndromes may lead to earlier diagnosis and thus prevent the expensive investigations. Both conditions have a dramatic improvement upon using corticosteroids therapy.