Early systemic lupus erythematos: onset with thrombosis
DOI:
https://doi.org/10.52692/1857-0011.2023.1-75.25Keywords:
Systemic lupus erythematosus, antiphospholipid syndrome, immunosuppressionAbstract
Systemic lupus erythematosus (SLE) is a global pathology that can affect people of any age, with an average age of onset between 15 and 44 years. The female/male ratio is 13:1, while in children and the elderly it is only 2:1 [2, 5]. SLE can affect any organ and presents a wide spectrum of clinical and immunological manifestations, being one of the conditions with the highest mortality rates among systemic diseases [10]. This article presents the clinical case of patient X, aged 19 years, with subacute SLE, with involvement of the skin, vessels, mucous membranes, kidneys, muscles, hematopoietic system, immune system and secondary seronegative antiphospholipid syndrome. The diagnosis was established based on clinical and immunological SLICC criteria, laboratory tests, ECG, EcoCG, chest X-ray, ultrasonography of internal organs, Doppler ultrasonography of lower limb vessels and brain MRI. Against the background of immunosuppressive, anticoagulant, antiplatelet treatment, the patient’s condition improved and she was discharged with the recommendation to continue the basic and symptomatic treatment.
References
Aringer M, Costenbader K, Daikh D, et al 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus Annals of the Rheumatic Diseases 2019;78:1151-1159.
Ben-Menachem, Erez MBCHB, MBA, FANZCA*. Systemic Lupus Erythematosus: A Review for Anesthesiologists. Anesthesia & Analgesia 111(3):p 665-676, September 2010. | DOI: 10.1213/ANE.0b013e3181e8138e
Cervera, Ricard; Khamashta, Munther A.; Font, Josep; Sebastiani, Gian Domenico; Gil, Antonio; Lavilla, Paz; Mejía, Juan Carlos; Aydintug, A. Olcay; Chwalinska-Sadowska, Hanna; de Ramón, Enrique; Fernández-Nebro, Antonio; Galeazzi, Mauro; Valen, Merete; Mathieu, Alessandro; Houssiau, Frédéric; Caro, Natividad; Alba, Paula; Ramos-Casals, Manuel; Ingelmo, Miguel; Hughes, Graham R.V. European Working Party on Systemic Lupus Erythematosus. Morbidity and Mortality in Systemic Lupus Erythematosus During a 10-Year Period: A Comparison of Early and Late Manifestations in a Cohort of 1,000 Patients. Medicine 82(5):p 299-308, September 2003. | DOI: 10.1097/01.md.0000091181.93122.55
Mazur M., Mazur-Nicorici L., Vetrilă S., et all. Lupus eritematos sistemic la adult. PCN-318. Chișinău, 2020. P. 12-19.
Fava A, Petri M. Systemic lupus erythematosus: Diagnosis and clinical management. J Autoimmun. 2019 Jan;96:1-13. doi: 10.1016/j.jaut.2018.11.001. Epub 2018 Nov 16. PMID: 30448290; PMCID: PMC6310637.
Fava A, Petri M. Systemic lupus erythematosus: Diagnosis and clinical management. J Autoimmun. 2019 Jan;96:1-13. doi: 10.1016/j.jaut.2018.11.001. Epub 2018 Nov 16. PMID: 30448290; PMCID: PMC6310637.
Chaturvedi S, Braunstein EM, Brodsky RA. Antiphospholipid syndrome: Complement activation, complement gene mutations, and therapeutic implications. J Thromb Haemost. 2021 Mar;19(3):607-616. doi: 10.1111/ jth.15082. Epub 2021 Feb 10. PMID: 32881236; PMCID: PMC8080439.
Jose A. Gómez-Puerta, Ricard Cervera, Diagnosis and classification of the antiphospholipid syndrome, Journal of Autoimmunity, Volumes 48–49, 2014, Pages 20-25,ISSN 0896-8411
Somers E, Magder LS, Petri M. Antiphospholipid antibodies and incidence of venous thrombosis in a cohort of patients with systemic lupus erythematosus. J Rheumatol. 2002 Dec;29(12):2531-6. PMID: 12465147.
Demas KL, Costenbader KH. Disparities in lupus care and outcomes. Curr Opin Rheumatol. 2009 Mar;21(2):102-9. doi: 10.1097/BOR.0b013e328323daad. PMID: 19339919; PMCID: PMC2774141.
Bertsias G, Ioannidis JP, Boletis J, Bombardieri S, Cervera R, Dostal C, Font J, Gilboe IM, Houssiau F, Huizinga T, Isenberg D, Kallenberg CG, Khamashta M, Piette JC, Schneider M, Smolen J, Sturfelt G, Tincani A, van Vollenhoven R, Gordon C, Boumpas DT; Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis. 2008 Feb;67(2):195-205. doi: 10.1136/ ard.2007.070367. Epub 2007 May 15. PMID: 17504841.
Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011 Dec 1;365(22):2110-21. doi: 10.1056/NEJMra1100359. PMID: 22129255.
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