ISSN: 2578-4676
Authors: Malaweera A* and Huang LL
Introduction: Systemic lupus erythematosus (SLE) is an autoimmune systemic disease that presents heterogeneously with multiple organ involvement with varying severity. It is more common in women of child bearing age and majority of studies have noted increased SLE activity during pregnancy, causing peri-partum complications like pre-eclampsia, preterm labour and stillbirth. Our case describes a young female patient presenting post-partum with florid signs and symptoms of diffuse SLE. This highlights the importance of considering autoimmune disease as part of a wide differential diagnosis; to aid prompt diagnosis with thorough clinical assessment, laboratory autoimmune panel testing and management of the organ disease with an appropriate level of immunosuppression, to improve the overall disease prognosis. Case Presentation: We present a 31-year-old woman who suffered pre-eclampsia during her pregnancy, presenting one month postpartum with haemolytic anaemia, decompensated cardiomyopathy with serositis and acute renal impairment. She was diagnosed with systemic lupus erythematosus with lupus nephritis and started on immunosuppressive therapy with hydroxychloroquine, corticosteroids and mycophenolate mofetil. After treatment, she has had improvement in her renal impairment, haemolytic anaemia, serositis and her autoimmune markers. Conclusion: This case highlights the highly heterogeneous presentation of SLE and its close interaction between pregnancy and its outcomes. It is important to have a low threshold for consideration of autoimmune diseases like SLE in a young female presenting with above symptoms. The overall management of an individual with SLE should be carried out in a multidisciplinary team involving physicians of different specialties, nursing and allied health staff and psychologists.
Keywords: SLE; Lupus Nephritis; AKI; Immunosuppression; Pregnancy
