[A case of pregnant woman with lupus anticoagulant positive systemic lupus erythematosus complicated with intrauterine fetal death, eclampsia, and brainstem vascular damage].
A 28-year-old female patient with SLE was found to have complications from intrauterine fetal death, eclampsia, and brainstem vascular damage during pregnancy. These symptoms were associated with lupus anticoagulant (LAC). An LAC positive SLE case with accompanying cerebrovascular disease and fetal loss at the same time has rarely been reported. The first brain CT scan revealed the presence of multiple middle pons infarction. Ten days after onset, a brain MRI showed the change into hemorrhagic infarction in the same region, suggesting disseminated intravascular coagulation (DIC) caused by severe obstetric complications. Although the severity of the brain damage implied poor prognosis, her symptoms were alleviated by intensive care with a large amount of steroid therapy and active rehabilitation. LAC-positive SLE patients are apt to encounter obstetric complications in pregnancy. Therefore they must be treated by medical specialists in cooperation with gynecologists. When they also have accompanying with cerebrovascular diseases, active therapy for SLE is necessary for a good prognosis.
First Department of Internal Medicine, National Defense Medical College, Saitama.
T
T
Ishizuka
K
K
Suzuki
M
M
Hara
S
S
Nakajima
T
T
Hirose
M
M
Harigai
T
T
Hidaka
S
S
Kawaguchi
M
M
Kawagoe
H
H
Nakamura
D000328:Adult; D001933:Brain Stem / Q000098:blood supply*; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D004461:Eclampsia / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D011249:Pregnancy Complications, Cardiovascular; D011379:Prognosis
D016682:Lupus Coagulation Inhibitor