Fatal pneumococcal epiglottitis in lupus overlap syndrome

A 35-year-old woman with a six-year history of polymyositis, having developed a vasculitic skin rash in the first trimester of her first pregnancy and biopsy-proven lupus glomerulonephritis during the third trimester is described. Investigations performed one month post-partum revealed high DNA binding, the presence of RNP antibodies, a serum CH50 of 0% and a serum C2 of 1%. Despite marked clinical and serological improvement and the reduction of her prednisolone dose to 5 mgs./day, she died at one-year post-partum of acute pneumococcal epiglottitis.