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Severe Maternal Morbidity Associated with Systemic Lupus Erythematosus Flare in the Second Trimester of Pregnancy
Joint Authors
Blitz, Matthew J.
Fleischer, Adiel
Source
Case Reports in Obstetrics and Gynecology
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-05-10
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Pregnancy in women with systemic lupus erythematosus (SLE) is associated with an increased risk of adverse maternal and fetal outcomes.
Here, we present a case of severe maternal morbidity in a 23-year-old primigravida with SLE and secondary Sjögren’s syndrome who experienced a life-threatening multisystem flare at 17 weeks of gestational age.
She presented to the emergency department complaining of cough with hemoptysis and shortness of breath.
She developed hypoxic respiratory failure and was admitted to the intensive care unit.
Bronchoscopy confirmed diffuse alveolar hemorrhage.
Physical exam and laboratory evaluation were consistent with an active SLE flare, pancytopenia, and new-onset lupus nephritis.
After counseling regarding disease severity, poor prognosis, and recommendation for therapy with cytotoxic agents, she agreed to interruption of pregnancy which was achieved by medical induction.
Her course was further complicated by thrombotic microangiopathy and generalized tonic-clonic seizures attributable to posterior reversible encephalopathy syndrome versus neuropsychiatric SLE.
This case represents one of the most extreme manifestations of lupus disease activity associated with pregnancy that has been reported in the literature and emphasizes the importance of preconception evaluation and counseling and a multidisciplinary management approach in cases with a complex and evolving clinical course.
American Psychological Association (APA)
Blitz, Matthew J.& Fleischer, Adiel. 2018. Severe Maternal Morbidity Associated with Systemic Lupus Erythematosus Flare in the Second Trimester of Pregnancy. Case Reports in Obstetrics and Gynecology،Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1145785
Modern Language Association (MLA)
Blitz, Matthew J.& Fleischer, Adiel. Severe Maternal Morbidity Associated with Systemic Lupus Erythematosus Flare in the Second Trimester of Pregnancy. Case Reports in Obstetrics and Gynecology No. 2018 (2018), pp.1-6.
https://search.emarefa.net/detail/BIM-1145785
American Medical Association (AMA)
Blitz, Matthew J.& Fleischer, Adiel. Severe Maternal Morbidity Associated with Systemic Lupus Erythematosus Flare in the Second Trimester of Pregnancy. Case Reports in Obstetrics and Gynecology. 2018. Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1145785
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145785