Systemic lupus erythematosus and secondary antiphospholipid syndrome in native sisters with reduced fertility

Systemic lupus erythematosus (SLE) and secondary anti-phospholipid syndrome (APS II) can cause increased morbidity and mortality of the fetus. We followed the course of fertility of two sisters with these two basic diseases.

In the Center for Immunology of Reproduction, we confi rmed both sisters had increased levels of some selected anti-phospholipid antibodies (against phosphatidylserine, phosphatidylethanolamine, phosphatidylinositol, DL-glycerole, anexin V, phoshatidic acid, cardiolipin, beta2-glycoprotein I), anti-nuclear, and anti-DNA antibodies. During the established immunosuppressive and hormonal therapy at the time of SLE remission, both sisters became pregnant. There was a physiological progression of pregnancy until the 19th week.

At the 20th week of pregnancy, the older sister miscarried again, and the younger sister developed hypertension in the 31st week of pregnancy which was terminated by caesarean section.

In our causal evaluation, we addressed two serious autoimmune diseases (SLE, APS II) in two sisters and described their course of pregnancy. However, only one of them became a happy mother.