SARS-CoV2-induced Schnitzler syndrome, inflammatory flare and successful treatment by anakinra during pregnancy: a case report.
Louise Weible, Britta Maurer, Nicola Andina et al.
✦ AI-curated · Sources linked
Case in brief
A pregnant woman in her early 40s with established Schnitzler syndrome developed urticaria, musculoskeletal symptoms and elevated inflammatory markers during SARS-CoV-2 infection, consistent with an inflammatory flare. Her underlying diagnosis had been supported by chronic urticaria and monoclonal gammopathy, meeting clinical diagnostic criteria. Given symptom severity and the role of interleukin-1 in the disease, she received anakinra. Symptoms resolved rapidly and inflammatory parameters normalised. Treatment was well tolerated, with favourable maternal and fetal outcomes during pregnancy.
What made this case unusual
The case describes a SARS-CoV-2-associated Schnitzler syndrome flare during pregnancy and its successful treatment with anakinra, a setting in which the abstract notes that management data are extremely limited.
Diagnostic / clinical pearl
In a patient with known Schnitzler syndrome, urticaria and musculoskeletal symptoms with raised inflammatory markers during SARS-CoV-2 infection may represent disease reactivation; consider the infection-associated flare in the clinical assessment.
Why it matters
The reported favourable maternal and fetal outcomes add a case-level observation on anakinra use for a severe inflammatory flare during pregnancy, without establishing broader safety or efficacy.