Postpartum uveitis

A review of the literature supports the concept that serum levels of corticosteroids are elevated during pregnancy. Even a concurrent increase in cortisol binding globulin (CBG) does not entirely neutralize the increased levels of cortisol. Thus, body tissues are exposed to more free cortisol than in the nonpregnant state. After delivery there is a rapid reduction of serum corticosteroids to the nonpregnant level. A granulomatous disease such as sarcoidosis may be suppressed by the high serum cortisol level. In the puerperium with a reduction of the serum cortisol, exacerbation of such a disease is likely. The case presented demonstrates this phenomenon.