scholarly journals Therapeutic Challenges in Systemic Lupus Erythematosus Patient with Pregnancy, Osteoporosis, and Severe Thrombocytopenia: A Case Report and Review of Literature

2021 ◽  
Vol 31 (3) ◽  
pp. 162
Author(s):  
Yosefin Ratnaningtyas ◽  
Perdana Aditya Rahman
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Severe Case ◽  
Corticosteroid Treatment ◽  
Severe Thrombocytopenia ◽  
Systemic Lupus ◽  
Autoimmune Conditions ◽  
Routine Therapy ◽  
First Time

<p>Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease that requires long-term corticosteroid treatment that may lead to osteoporosis characterized by low bone mass and microarchitectural deterioration of the trabecular and cortical skeletal. This study presents a severe case of thrombocytopenia in a 25-year old woman with SLE and osteoporosis who underwent routine therapy and was pregnant for the first time. The complexity of pregnancy and autoimmune conditions create therapeutic challenges that need to be considered in SLE patients with pregnancy, osteoporosis, and severe thrombocytopenia.</p>

Long-Term Treatment of the Patient with Systemic Lupus Erythematosus

1975 ◽  
Vol 37 (6) ◽  
pp. 924-929 ◽  
Author(s):  
Hideaki YAMAURA ◽  
Masaharu RIKIMARU ◽  
Isamu TAKAHASHI ◽  
Sadao ANAN ◽  
Tomio AKIYAMA ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Term Treatment ◽  
Systemic Lupus ◽  
Long Term Treatment

A Long-Term Study of Hydroxychloroquine Withdrawal on Exacerbations in Systemic Lupus Erythematosus

Lupus ◽  
1998 ◽  
Vol 7 (2) ◽  
pp. 80-85 ◽  
Author(s):  
◽  
E Tsakonas ◽  
L Joseph ◽  
J M Esdaile ◽  
D Choquette ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Term Study ◽  
Long Term Study

Graves' Disease, Hypoparathyroidism, Systemic Lupus Erythematosus, Alopecia, and Angioedema: Autoimmune Polyglandular Syndrome Variant or Coincidence?

2013 ◽  
Vol 26 (1) ◽  
pp. 217-222 ◽  
Author(s):  
E. Melcescu ◽  
E.H. Kemp ◽  
V. Majithia ◽  
V. Vijayakumar ◽  
G.I. Uwaifo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Calcium Supplementation ◽  
Parathyroid Glands ◽  
Irradiation Damage ◽  
Graves Disease ◽  
Systemic Lupus ◽  
Autoimmune Polyglandular Syndrome ◽  
Casr Gene ◽  
Autoimmune Conditions

Data on coexisting Graves' disease (GD), hypoparathyroidism, and systemic lupus erythematosus (SLE) are limited. The thyroid and parathyroid glands may be extra sensitive to irradiation damage in an underlying autoimmune condition. A 34-year-old black woman presented with tetanic-like cramps, easy skin bruising, fatigue, weight gain, nocturia and back pain. She was previously diagnosed with GD in 2001 and underwent radioiodine therapy (RAI) in 9/01 using 6 mCi. PostRAI (November 2001) she developed hypocalcemia and hypothyroidism (2/02). In 2007, SLE was diagnosed. In October 2009, s-calcium and PTH were still low at 7.1 mg/dl and 9 pg/mL, respectively, although the patient denied symptoms on vitamin D and calcium supplementation. To identify possible autoimmune damage of the parathyroids, we evaluated the presence of activating antibodies to the CaSR and also analyzed the DNA sequence of all 6 translated exons and flanking intronic sequences of her CaSR gene for a functionally significant CaSR mutation but neither was positive. The initial autoimmune damage to her thyroid and possibly parathyroid glands followed by irradiation of them seems to have contributed to her developing both hypoparathyroidism (11/01) and hypothyroidism (2002). The patient could potentially have had parathyroid autoantibodies in 2001 that disappeared by 2009 when she was tested for them. We consider that the multiple autoimmune conditions developed over the past decade of her life with the concurrent irradiation contributing to her brittle hypoparathyroidism. Select patients with GD and perhaps parathyroid autoantibodies with a slowly developing destructive impact on the parathyroid glands may then develop overt hyoparathyroidism with rather low dose RAI ablation. This patient adds to the evolving spectrum of polyglandular syndrome variants.

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