New-Onset Systemic Lupus Erythematosus during Pregnancy: A Case Report

Document Type : Case Report

Authors

1 USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran

2 Department of Internal Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that involves multiple organs. Pregnant women previously diagnosed with SLE are at risk of experiencing gestational complications. However, cases of initial SLE manifestation during pregnancy are rare.
Case Presentation: A 45-year-old pregnant woman (G7P2Ab4) was admitted to Shahid Rahimi Hospital in Khorramabad, Iran, in the 29th week of gestation due to thrombocytopenia. The patient had received a diagnosis of SLE during a routine prenatal visit but had not responded to the prescribed medications. After a comprehensive clinical and paraclinical evaluation, the patient was treated with pulse intravenous methylprednisolone, followed by prednisolone, dramatically improving her clinical condition.
Conclusion: Diagnosing and managing SLE during pregnancy can be controversial. An accurate evaluation of the patient’s clinical condition is essential for determining the most effective treatment strategy. A multidisciplinary approach is necessary to ensure the best possible outcomes for the mother and the fetus.

Highlights

Golnaz Mahmoudvand (Google Scholar), (PubMed)

Arian Karimi Rouzbahani (Google Scholar), (PubMed)

How to Cite: Mahmoudvand G, Torang HA, Karimi Rouzbahani A. New-Onset Systemic Lupus Erythematosus during Pregnancy: A Case Report. Women. Health. Bull. 2023;10(3):210-213. doi: 10.30476/WHB.2023.98872.1231.

Keywords

References

Fava A, Petri M. Systemic lupus erythematosus: Diagnosis and clinical management. J Autoimmun. 2019;96:1-13. doi: 10.1016/j.jaut.2018.11.001. PubMed PMID: 30448290; PubMed Central PMCID: PMC6310637. ## 2. Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W. The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology (Oxford). 2017;56(11):1945-61. doi: 10.1093/rheumatology/kex260. PubMed PMID: 28968809. ## 3. Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677-86. doi: 10.1002/art.34473. PubMed PMID: 22553077; PubMed Central PMCID: PMC3409311. ## 4. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725. doi: 10.1002/art.1780400928. PubMed PMID: 9324032. ## 5. Kuhn A, Bonsmann G, Anders HJ, Herzer P, Tenbrock K, Schneider M. The Diagnosis and Treatment of Systemic Lupus Erythematosus. Dtsch Arztebl Int. 2015;112(25):423-32. doi: 10.3238/arztebl.2015.0423. PubMed PMID: 26179016; PubMed Central PMCID: PMC4558874. ## 6. Gluhovschi C, Gluhovschi G, Petrica L, Velciov S, Gluhovschi A. Pregnancy Associated with Systemic Lupus Erythematosus: Immune Tolerance in Pregnancy and Its Deficiency in Systemic Lupus Erythematosus--An Immunological Dilemma. J Immunol Res. 2015;2015:241547. doi: 10.1155/2015/241547. PubMed PMID: 26090485; PubMed Central PMCID: PMC4451247. ## 7. Bellou AM, Bös D, Kukuk G, Gembruch U, Merz WM. Enteritis as initial manifestation of systemic lupus erythematosus in early pregnancy: A case report. Medicine (Baltimore). 2018;97(17):e0401. doi: 10.1097/md.0000000000010401. PubMed PMID: 29702988; PubMed Central PMCID: PMC5944493. ## 8. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Glob Adv Health Med. 2013;2(5):38-43. doi: 10.7453/gahmj.2013.008. PubMed PMID: 24416692; PubMed Central PMCID: PMC3833570. ## 9. Alkaabi JK, Alkindi S, Riyami NA, Zia F, Balla LM, Balla SM. Successful treatment of severe thrombocytopenia with romiplostim in a pregnant patient with systemic lupus erythematosus. Lupus. 2012;21(14):1571-4. doi: 10.1177/0961203312463621. PubMed PMID: 23161577. ## 10. Baer AN, Witter FR, Petri M. Lupus and pregnancy. Obstet Gynecol Surv. 2011;66(10):639-53. doi: 10.1097/OGX.0b013e318239e1ee. PubMed PMID: 22112525. ## 11. Daskalakis G, Papantoniou N, Marinopoulos S, Vomvolaki E, Papageorgiou I, Mesogitis S, et al. Systemic lupus erythematosus - associated acute severe thrombocytopenia and leukopenia first presented in pregnancy. Fetal Diagn Ther. 2005;20(6):540-3. doi: 10.1159/000088047. PubMed PMID: 16260892. ## 12. Wu L, Jiang XQ, Xiong YQ, Lin XM. Muscle weakness of the lower limbs after epidural anesthesia in a pregnant woman with undiscovered systemic lupus erythematosus. Chin Med J (Engl). 2020;133(5):621-2. doi: 10.1097/cm9.0000000000000665. PubMed PMID: 32032082; PubMed Central PMCID: PMC7065854. ##

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