A complicated multisystem flare of systemic lupus erythematosus during pregnancy.
We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy. We discuss the therapeutic options available in pregnancy, and highlight the importance of cross-specialty multidisciplinary care in these women.
Imperial College London, London, UK.|Imperial College Healthcare NHS Trust, London, UK.
Philip
P
Webster
Imperial College Healthcare NHS Trust, London, UK.|Women's Directorate Office, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Catherine
C
Nelson-Piercy
Imperial College London, London, UK.|Imperial College Healthcare NHS Trust, London, UK.
Liz
L
Lightstone
D000328:Adult; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000151:congenital / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome
D007166:Immunosuppressive Agents