A maternal death complicated by systemic lupus erythematosus: a case report

Bu makale preeklampsi, nefrit, perikardiyal effüzyon ve yaygın pulmoner konjesyon ile komplike olan sistemik lupus eritematozuslu gebe bir kadının olgu sunumudur. Nefrit SLE’nin en ciddi komplikasyonlarından biri olarak bilinir ve kötü prognozun en güçlü göstergesidir. Olgunun ilk gebeliği idi ve 27. gebelik haftasında idi. Bizim hastamızda gebelik sonrasında lupus hastalığı alevlenmişti. Serum albümin düzeyinde düşme, ANA ve anti-ds DNA antikor yüksekliği, proteinüri, perikardiyal effüzyon, masif pulmoner konjesyon ve hipertansiyon risk faktörleri idi. Böylece, birçok risk faktörü taşıyan hastamızda preeklampsi gelişti ve hasta öldü.

Sistemik lupus eritematozus ile komplike bir anne ölümü: olgu sunumu

This paper is a case report of a pregnant woman with systemic lupus erythematosus (SLE) complicated by preeclampsia, nephritis, pericardial effusion, and massive pulmonary congestion. Nephritis is known to be one of the most serious complications of SLE and is a strong predictor of poor outcome. She was a primigravida in the 27th week of gestation. In our patient, postgestational lupus flare up was noted. Risk factors included lower serum albumin, elevated serum ANA and anti-ds DNA antibody, proteinuria, pericardial effusion, massive pulmonary congestion, and hypertension. Thus, our patient had many risk factors to develop preeclampsia and she died.

PDF

___

1. Radeka G, Novakov-Mikic A, Mitic I. Systemic lupus erythema tosus in pregnancy--case report. Med Pregl. 2005 May-Jun; 58(5-6):301-307.
2. Sadowska A. [Pregnancy in women with systemic lupus erythematosus (SLE)] Przegl Lek. 2005; 62(1): 61-64.
3. Vanini G, Chizzolini C. [Systemic lupus erythematosus (SLE): sexual hormones, contraception and pregnancy] Rev Med Suisse. 2005 Apr 13; 1(15): 991-4. Review.
4. Tandon A, Ibanez D, Gladman DD, Urowitz MB. The effect of pregnancy on lupus nephritis. Arthritis Rheum. 2004 Dec; 50(12): 3941- 3946
5. Moroni G, Ponticelli C. Pregnancy after lupus nephritis. Lupus. 2005; 14(1): 89-94.
6. Molad Y, Borkowski T, Monselise A, Ben-Haroush A, Sulkes J, Hod M, Feldberg D, Bar J. Maternal and fetal outcome of lupus pregnancy: a prospective study of 29 pregnancies. Lupus. 2005; 14(2):145-151.
7. Yang CH, Chen JY, Lee SC, Luo SF. Successful preventive treatment of congenital heart block during pregnancy in a woman with systemic lupus erythematosus and anti-Sjogren’s syndrome A/Ro antibody. J Microbiol Immunol Infect. 2005 Oct; 38(5): 365-369.
8. Egerman RS, Ramsey RD, Kao LW, Bringman JJ, Bush AJ, Wan JY. Hypertensive disease in pregnancies complicated by systemic lupus erythematosus. Am J Obstet Gynecol. 2005 Nov; 193(5): 1676-1679.
9. Hildbrand P, Eigenmann C, Gugger M, Marti HP, Hullin R. Preeclampsia with acute heart failure postpartum as primary manifestation of systemic lupus erythematosus. Eur J Heart Fail. 2005 Oct; 7(6): 1057-1058.