[Central nervous system involvement in systemic lupus erythematosus].

Area of Science:

• Rheumatology
• Obstetrics and Gynecology
• Vascular Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems.
• Pregnancy in SLE patients presents unique challenges and risks for both mother and fetus.
• Antiphospholipid syndrome (APS) is a prothrombotic disorder often associated with SLE, increasing the risk of thromboembolic events.

Purpose of the Study:

• To report a rare case of SLE in pregnancy complicated by severe thromboembolic events and pneumonia.
• To discuss the diagnostic and management challenges in such complex cases.
• To emphasize the importance of early recognition and multidisciplinary care for pregnant patients with SLE and APS.

Main Methods:

• Case report of a 22-year-old pregnant patient (33 weeks gestation) with diagnosed SLE.
• Review of medical history, clinical presentation, laboratory findings, and instrumental studies.
• Analysis of serological tests for autoimmune markers and thrombotic indicators.

Main Results:

• The patient presented with ischemic stroke, inferior vena cava and lower extremity deep vein thrombosis, and polysegmental pneumonia.
• Elevated inflammatory markers (CRP, ESR, IL-6), D-dimer, and positive autoantibodies (anti-SmD1, anticardiolipin) were observed.
• The patient had a history of postpartum complications and experienced flu-like symptoms during pregnancy.

Conclusions:

• This case underscores the critical risk of severe thrombotic complications in pregnant SLE patients, particularly those with secondary APS.
• Prompt diagnosis and aggressive management are crucial for improving outcomes in these high-risk pregnancies.
• Multidisciplinary collaboration between rheumatologists, obstetricians, and vascular specialists is essential.