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Itchy wheals and purulent pustules: instead of enjoying her pregnancy, British Fiona Hooker suffered. The reason for this is a very rare autoimmune disease.
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- Fee Anabelle Riebeling
The 32-year-old suffers from pemphigoid gestationis, a blistering autoimmune skin disease.
Kennedy News and Media
As a result, the pregnancy was anything but comfortable.
Kennedy News and Media
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Fiona Hooker was plagued by itchy hives and pustules during her second pregnancy.
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The British woman was diagnosed with pemphigoid gestationis.
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This is a very rare autoimmune disease in which autoantibodies are directed once morest a molecule in the placenta.
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Since the disease can flare up once more and once more, Hooker and her partner refrain from having more children.
Everything was fine up until the 31st week of pregnancy. Then Fiona Hooker from Basingstoke, UK, noticed itchy red spots on her stomach for the first time: “I had a few tiny, really itchy spots around my navel that felt like hives,” said the 32-year-old.
After the rash and itching got progressively worse, the expectant mother went to see a doctor. But it was only the third family doctor who finally recognized the problem: “He said it looked like pemphigoid gestationis (see box) and he referred me to a dermatologist. He gave me the strongest cortisone ointment you can get. It was like being allergic to my own baby.” At the time, the pregnant woman’s body was already covered with red, itchy wheals and purulent pustules.
Pemphigoid gestationis is an autoimmune blistering skin disease. The cause is certain autoantibodies. This refers to special proteins (antibodies) of the immune system that are directed once morest endogenous substances (Greek autos – “self”). In pemphigoid gestationis, the autoantibodies bind to a structure called pemphigoid bullous antigen 2, or BPAg2 for short, that anchors the epidermis to the dermis. The binding of the antibodies causes the skin to become inflamed and the epidermis to peel off. There is much to suggest that the autoantibodies are not primarily formed once morest the skin, but once morest a molecule in the placenta. The disease is very rare outside of pregnancy. It usually occurs in the second or third trimester of pregnancy. The condition is so rare that the largest study conducted on treatment only 87 patients includes.
Rash worse following childbirth
A condition that became unbearable for Hooker in the 35th week. “I’m in an emergency because I mightn’t take it anymore. There I was given oral cortisone.” And that helped at first. But two days before the birth the situation changed once more: “It became unbearable once more and 24 hours following the birth the rash exploded once more and blisters formed once more. Scratching felt good, but it scraped my skin. So I ended up with sore skin and the blisters came back too.”
“It hurt a lot to hold my son.”
The wheals and pustules no longer only covered her stomach, but also all her limbs and chest. This made it almost impossible for her to hold her son at all: “It hurt a lot to hold my son, so I mightn’t really enjoy the newborn phase,” says the mother of two. Five days following the birth, a blood test finally confirmed the doctors’ suspicions: Hooker has pemphigoid gestationis.
The doctors suspect that the reaction was triggered by a gene in her son’s DNA, as she did not have the disease in her first pregnancy with her now three-year-old daughter Phoebe, according to the British woman.
No more children
The cortisone treatment lasted six months until the wheals and pustules finally disappeared. To this day, Hooker still has to put on lotion every now and then and will suffer from mild flare-ups for the rest of her life. Knowing that the disease can recur in future pregnancies, the hypnobirthing teacher and her husband Warren Hooker, 35, have decided not to have any more children. Fiona Hooker is now hoping to raise awareness of the rare pregnancy condition. She herself had never heard of it until she was diagnosed.
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