Pregnancy in Wegener’s granulomatosis (WG) has been rare, but increasing numbers of pregnancies are now being reported, not least because of the use of less toxic drug regimens. New onset disease during or after pregnancy has been noted previously, but postpartum relapse has not been reported so far. Here, we report a severe postpartum relapse of WG after longstanding remission.

A 27 year old woman was first diagnosed with WG of the upper and lower respiratory tract, central nervous system, eye, and skin in 1995. Treatment with methylprednisolone (500 mg/day for 5 days), oral cyclophosphamide (3 mg/kg), intravenous immunoglobulins, and co-trimoxazole induced remission. Cyclophosphamide was stopped in 1996. Prednisolone and co-trimoxazole were stopped in August 1997 and June 1999, respectively, while the patient continued to be in full remission.

The patient subsequently became pregnant, with an uneventful delivery in September 2000 and a normal …