{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:00:49Z","timestamp":1754193649809,"version":"3.41.2"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Anakinra, an interleukin-1 receptor antagonist (IL-1 Ra), is a treatment option for recurrent pericarditis refractory to conventional therapy. However, some patients cannot discontinue anakinra treatment without relapse. This is of particular concern for women of childbearing age, as data on its safety during pregnancy and lactation is limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report the case of a 36-year-old White woman with recurrent pericarditis of an inflammatory phenotype. Pericardial biopsy revealed virus-negative fibro-productive pericarditis, and genetic testing showed no identifiable cause. Despite treatment with non-steroidal anti-inflammatory drugs, colchicine, and corticosteroids, the patient experienced multiple recurrences and developed corticosteroid-related side effects. Introduction of anakinra resulted in immediate clinical improvement and allowed corticosteroid withdrawal. However, several attempts to discontinue anakinra led to pericarditis recurrences. The patient tested positive for neutralizing anti-IL-1Ra antibodies. During the stable phase of the disease, as confirmed by cardiac magnetic resonance imaging, and while on anakinra and colchicine, she conceived spontaneously. She maintained anakinra treatment throughout the full-term pregnancy and breastfeeding, with no impact on foetal or child development.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our paper provides evidence supporting the safe use of anakinra in pregnancy and lactation in a patient with recurrent pericarditis. It also reports the first case of anti-IL-1Ra antibodies in a patient receiving anakinra for recurrent pericarditis, which may help explain the dependency on the medication. The potential role of these antibodies as biomarkers for anakinra dependency or tools for optimizing immunosuppressive treatment warrants further research. A patient-centred counselling and a multidisciplinary approach are essential for achieving optimal outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf280","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T08:21:50Z","timestamp":1749111710000},"source":"Crossref","is-referenced-by-count":1,"title":["Anakinra during pregnancy and lactation for corticosteroid-dependant colchicine-resistant recurrent pericarditis in a patient with neutralizing anti-interleukin-1 receptor antagonist antibodies: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-0643","authenticated-orcid":false,"given":"Andreja","family":"Cerne Cercek","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Centre Ljubljana , Zaloska cesta 7, 1000 Ljubljana ,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alja","family":"Gomiscek Novak","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Centre Ljubljana , Zaloska cesta 7, 1000 Ljubljana ,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-2856","authenticated-orcid":false,"given":"Andreja","family":"Trojner Bregar","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana , Slajmerjeva cesta 3, 1000 Ljubljana ,","place":["Slovenia"]},{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana , Vrazov trg 2, 1000 Ljubljana ,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-9092","authenticated-orcid":false,"given":"Tadej","family":"Avcin","sequence":"additional","affiliation":[{"name":"Department of Allergology, Rheumatology and Clinical Immunology, Children\u2019s Hospital, University Medical Centre Ljubljana , Bohoriceva 20, 1000 Ljubljana ,","place":["Slovenia"]},{"name":"Department of Pediatrics, Faculty of Medicine, University of Ljubljana , Vrazov trg 2, 1000 Ljubljana ,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0638-2949","authenticated-orcid":false,"given":"Christoph","family":"Kessel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology and Immunology, University Children\u2019s Hospital M\u00fcnster , Albert-Schweitzer-Campus 1, Geb\u00e4ude W30, 48149 M\u00fcnster ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8167-2989","authenticated-orcid":false,"given":"Lorenz","family":"Thurner","sequence":"additional","affiliation":[{"name":"Jos\u00e9 Carreras Center for Immuno and Gene Therapy and Department of Internal Medicine I, Saarland University , Kirrberger Str. 100 Geb\u00e4ude 45.3, 66421 Homburg\/Saar ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Fadle","sequence":"additional","affiliation":[{"name":"Jos\u00e9 Carreras Center for Immuno and Gene Therapy and Department of Internal Medicine I, Saarland University , Kirrberger Str. 100 Geb\u00e4ude 45.3, 66421 Homburg\/Saar ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6193-0349","authenticated-orcid":false,"given":"Miha","family":"Cercek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Centre Ljubljana , Zaloska cesta 7, 1000 Ljubljana ,","place":["Slovenia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"2025063002561088500_ytaf280-B1","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC guidelines for the diagnosis and management of pericardial diseases: the task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) endorsed by: the European association for cardio-thoracic surgery (EACTS)","volume":"36","author":"Adler","year":"2015","journal-title":"Eur Heart J"},{"key":"2025063002561088500_ytaf280-B2","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s11739-018-1907-x","article-title":"Recurrent pericarditis: still idiopathic? 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