A unique presentation of multicentric reticulohistiocytosis in pregnancy

Authors

  • Philip Conaghan MBBS,

    Rheumatology Registrar
    1. Departments of Rheumatology, Tissue Pathology and Dermatology, Monash Medical Centre, Melbourne, Australia
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  • Marian Miller MBBS, FRACP,

    Consultant Rheumatologist
    1. Departments of Rheumatology, Tissue Pathology and Dermatology, Monash Medical Centre, Melbourne, Australia
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  • John P. Dowling MBBS, FRCPA, MRCpath,

    Director Of Tissue Pathology
    1. Departments of Rheumatology, Tissue Pathology and Dermatology, Monash Medical Centre, Melbourne, Australia
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  • Peter Cowen MBBS, FACD,

    Consultant Dermatologist
    1. Departments of Rheumatology, Tissue Pathology and Dermatology, Monash Medical Centre, Melbourne, Australia
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  • Geoffrey Littlejohn MD, FRACP

    Director Of Rheumatology
    1. Departments of Rheumatology, Tissue Pathology and Dermatology, Monash Medical Centre, Melbourne, Australia
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Abstract

We describe a patient with multicentric reticulo-histiocytosis who presented, during the second trimester of pregnancy, with symmetric polyarthritis, marked erythematous, pulsatile synovial swelling of the distal interphalangeal joints of both hands, and widespread telangiectasias. She did not have the typical skin manifestations of multicentric reticulohistiocytosis. The erythema and pulsatility of the synovial swellings of the distal interphalangeal joints resolved after delivery, but she continued to have widespread active synovitis, which did not resolve until treatment with low-dose oral methotrexate was instituted.

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