A 25-Year-Old Saudi Woman with a 2-Year History of Antisynthetase Syndrome with Interstitial Lung Disease Who Commenced Azathioprine Treatment in the Third Trimester of Pregnancy and Had a Successful Birth at Term

Patient: Female, 25-year-old Final Diagnosis: Antisynthetase syndrome Symptoms: Arthritis • pregnancy • shortness of breath Medication: — Clinical Procedure: — Specialty: Obstetrics and Gynecology • Pulmonology • Rheumatology OBJECTIVE: Rare disease BACKGROUND: Antisynthetase syndrome (ASS) is a rare systemic autoimmune disease. The clinical features of ASS include interstitial lung disease (ILD), myositis, arthritis, Raynaud’s phenomenon, mechanic’s hands, and unexplained fever. There is a paucity of reported cases and management guidelines in pregnancy. This report describes the case of a 25-year-old Saudi woman with a 2-year history of ASS with ILD who commenced azathioprine treatment in the third trimester and had a successful birth at term. CASE REPORT: A 25-year-old Saudi primigravida woman with a 2-year history of ASS with ILD presented at 26 weeks of gestation after being lost to prepregnancy follow-up and discontinuing her medications. Azathioprine treatment was commenced, and despite poor prepregnancy follow-up, her pregnancy remained uneventful until 39 weeks, when fetal ultrasonography showed oligohydramnios. Therefore, labor induction was initiated, and she delivered vaginally with no postpartum complications or flare-ups. CONCLUSIONS: The multisystem autoimmune disease ASS is a rare condition, and there are no clinical guidelines for its management in pregnant women. This case report highlights some aspects of ASS management and the importance of a multidisciplinary approach.