Challenges in Management of Systemic Lupus Erythematosus on Pregnancy: A Single Case Report

Maya Oktari Yolanda, Kristo A. Nababan

2019

Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with unknown etiology. Pregnancy can trigger a recurrence of the disease or aggravate symptoms and threaten the lives of the mother and/or the baby whom she carries.Case:A pregnant woman who is 18 years old, complained thicked crust on the erythematous plaques distributed in the malar region, nasal, supraorbital and auricularsinistraetdextra region, discontinuous hair marks on the lateral side of the scalp, mild arthritis. Laboratory test results are leukocytosis (leukocyte 15,000 cells/µl; neutrophil 7.9 cells/µ; lymphocyte 6.29 cells/µ; monocyte 0.74 cells/µ), CRP 0.7mg/dl; C3 50mg/dl, ANATest 2.4; Anti-dsDNA 28. The result of kidney function testsis in the normal range. The USG results of a fetus: pregnancy in the uterus (8-9 weeks), childalive (31/01/2019). This patient has been diagnosed as SLE for three years but is well controlled with medication. However, the recurrence occurred when she is pregnant. This patient was diagnosed as mild SLE in pregnancy, and the recurrence was assessed using the Lupus Activity Index in Pregnancy (LAI-P) scale, and the score was 0.43. Then she was given the treatment with methylprednisolone 4mg once daily, ranitidine 150mg two times daily, paracetamol 500mg three times daily, folic acid400mg once daily, B-complex vitamin two times daily, desoximetasone 0.25% cream on the face, sunscreen, and also she was suggested to do a pregnancy control. In addition, she was also giveneducation about her diseases, to avoid direct sun exposure, drug side effects, psychological problems, how to deal with stress and keep a healthy diet and lifestyle.Conclusion: Pregnancy can trigger the recurrence of SLE or aggravate the symptom so that it can increase maternal and fetal mortality and morbidity. The treatment needs a multidisciplinary approach together with Internal medicine (Rheumatology) and Obstetrics department, close monitoringto checkif there is a change in clinical manifestation, vital signs, liver function test, kidney function test, hematology test, and also monitoring fetal development.

Paper Citation

in Harvard Style

Yolanda M. and Nababan K. (2019). Challenges in Management of Systemic Lupus Erythematosus on Pregnancy: A Single Case Report.In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI, ISBN 978-989-758-469-5, pages 411-415. DOI: 10.5220/0009990404110415

in Bibtex Style

@conference{ictromi19,
author={Maya Oktari Yolanda and Kristo A. Nababan},
title={Challenges in Management of Systemic Lupus Erythematosus on Pregnancy: A Single Case Report},
booktitle={Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,},
year={2019},
pages={411-415},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0009990404110415},
isbn={978-989-758-469-5},
}

in EndNote Style

TY - CONF

JO - Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease - Volume 1: ICTROMI,
TI - Challenges in Management of Systemic Lupus Erythematosus on Pregnancy: A Single Case Report
SN - 978-989-758-469-5
AU - Yolanda M.
AU - Nababan K.
PY - 2019
SP - 411
EP - 415
DO - 10.5220/0009990404110415