Systemic Lupus Erythematosus (SLE) with Hypertensive Crisis in Pregnancy
Case Report
DOI:
https://doi.org/10.55175/cdk.v52i4.1144Keywords:
Autoimmune disease, pregnancy complications, systemic lupus erythematosusAbstract
Introduction: Although SLE prevalence lacks specific Indonesian data, it predominantly affects women of childbearing age. Case: A 24-yearold pregnant woman with a history of SLE experienced worsening shortness of breath, leg swelling, and fatigue since her second month of pregnancy. Hospital admission revealed severe hypertensive crisis, active SLE affecting kidneys, joints, skin, congestive heart failure, and anemia. She underwent rigorous medical treatments and ICU monitoring. Discussion: SLE affects multiple organs. Careful management and monitoring are required during pregnancy for maternal and fetal well-being. Conclusion: Pregnant women with SLE may encounter various pregnancy-related complications. Effective and comprehensive management is vital to achieve favorable outcomes.
Downloads
References
Li J, Leng X, Li Z, Ye Z, Li C, Li X, et al. Chinese SLE treatment and research group registry: III. association of autoantibodies with clinical manifestations in Chinese patients with systemic lupus erythematosus. J Immunol Res. 2014;2014(1):1–8. DOI: 10.1155/2014/809389.
van Hagen PM, Dik WA, van Bilsen K. Lupus erythematosus. 2nd Ed. Encyclopedia of gastroenterology, second edition. Elsevier Inc.; 2019. p.472–76.
Tian J, Zhang D, Yao X, Huang Y, Lu Q. Global epidemiology of systemic lupus erythematosus: A comprehensive systematic analysis and modelling study. Ann Rheum Dis. 2023;82(3):351–6. DOI: 10.1136/ard-2022-223035.
Sumariyono S, Kalim H, Setyohadi B, Hidayat Ru, Najirman N, Hamijoyo L, et al. Rekomendasi Perhimpunan Reumatologi Indonesia: Diagnosis dan pengelolaan lupus eritematosus sistemik. 2019. Jakarta: Perhimpunan Reumatologi Indonesia; 2019.
Justiz Vaillant AA, Goyal A, Varacallo M. Systemic lupus erythematosus. Treasure Island (FL); 2023.
Fischer-Betz R, Specker C. Pregnancy in systemic lupus erythematosus and antiphospholipid syndrome. Best Pract Res Clin Rheumatol. 2017;31(3):397–414. DOI: 10.1016/j.berh.2017.09.011.
Andreoli L, Bertsias GK, Agmon-Levin N, Brown S, Cervera R, Costedoat-Chalumeau N, et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017;76(3):476–85. DOI: 10.1136/annrheumdis-2016-209770.
Zdrojewski Z. Systemic lupus erythematosus and antiphospholipid syndrome - diagnostic and therapeutic problems. Wiad Lek. 2018;71(1):40–6. PMID: 29558350.
Choe JY, Park SH, Kim JY, Jung HY, Kim SK. A case of systemic lupus erythematosus presenting as malignant hypertension with hypertensive retinopathy. Korean J Intern Med. 2010;25(3):341–4. DOI: 10.3904/kjim.2010.25.3.341.
Clowse MEB, Eudy AM, Balevic S, Sanders-Schmidler G, Kosinski A, Fischer-Betz R, et al. Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data. Lupus Sci Med. 2022;9(1):e000651. DOI: 10.1136/lupus-2021-000651.
Muhammad O, Jindal H, Sharath M, Khan AM, Choi S. Systemic lupus erythematosus with multi-organ involvement in a young female: Lymphadenopathy, lupus cerebritis, lupus nephritis, and cardiac manifestations. Cureus 2021;13(6):e15517. DOI: 10.7759/cureus.15517.
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019;78(9):1151–9. DOI: 10.1136/annrheumdis-2018-214819.
Pisetsky DS, Lipsky PE. Role of antinuclear antibody determinations in classification criteria for systemic lupus erythematosus: Comment on the article by Leuchten et al. Arthritis Care Res (Hoboken). 2019;71(5):696. DOI: 10.1002/acr23559.
Drosos GC, Vedder D, Houben E, Boekel L, Atzeni F, Badreh S, et al. EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis. 2022;81(6):768–79. DOI: 10.1136/annrheumdis-2021-221733.
Musa R, Brent LH, Qurie A. Lupus nephritis. National Library of Medicine [Internet]. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499817/.
Tamirou F, Houssiau FA. Management of lupus nephritis. J Clin Med. 2021;10(4):1–7. DOI: 10.3390/jcm10040670.
Baalbaki S, Szychowski JM, Tang Y, Wetta L, Subramaniam A. Systemic lupus erythematosus: Perinatal outcomes in patients treated with and without hydroxychloroquine. Ochsner J. 2020;20(4):362 LP – 367. DOI: 10.31486/toj.20.0013.
Duan J, Ma D, Wen X, Guo Q, Gao J, Zhang G, et al. Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis. Lupus 2021;30(7):1163–74. DOI: 10.1177/09612033211007199.
Huang PZ, Du PY, Han C, Xia J, Wang C, Li J, et al. Pre-eclampsia with new-onset systemic lupus erythematosus during pregnancy: A case report. World J Clin Cases. 2019;7(22):3800–6. DOI: 10.12998/wjcc.v7.i22.3800.
Miyamoto T, Hoshino T, Hayashi N, Oyama R, Okunomiya A, Kitamura S, et al. Preeclampsia as a manifestation of new-onset systemic lupus erythematosus during pregnancy: A case-based literature review. AJP Rep. 2016;6(1):1–7. DOI: 10.1055/s-0035-1566245.
Donohue S, Gomez S, Singh T, Garg S. Triphasic: Preeclampsia, systemic lupus erythematosus, and severe neutropenia with use of granulocyte colony stimulating factor in the partum and postpartum period. Arthritis Care Res (Hoboken). 2023;75(10):2036–43. DOI: 10.1002/acr.25138.
Sammaritano LR. Management of systemic lupus erythematosus during pregnancy. Annu Rev Med. 2017;68(1):271–85. DOI: 10.1146/annurev-med-042915-102658.
Saleh M, Sjowall C, Strevens H, Jönsen A, Bengtsson AA, Compagno M. Adverse pregnancy outcomes after multi-professional follow-up of women with systemic lupus erythematosus: An observational study from a single centre in Sweden. J Clin Med. 2020;9(8):1–7. DOI: 10.3390/jcm9082598.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Novierta Prima Kusumandaru, Calcarina Fitriani
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
