Preeclampsia, dilated cardiomyopathy and renal failure as the first manifestation of systemic lupus erythematosus: a case report

• Published in: Clinical rheumatology Vol. 28; no. 3; pp. 343 - 345
• Main Authors: Stepanková, J, Bürgelova, M, Honsova, E, Tesar, V, Vrbska, J, Viklicky, O
• Format: Journal Article
• Language: English
• Published: London London : Springer-Verlag 01.03.2009; Springer-Verlag; Springer Nature B.V
• Subjects: Adult; Algorithms; Autoimmune diseases; Cardiomyopathy, Dilated - diagnosis; Cardiomyopathy, Dilated - etiology; Case Report; Cesarean Section; congestive heart failure; Diagnosis, Differential; Early Diagnosis; Female; Gestational Age; HELLP Syndrome - diagnosis; Humans; Immunosuppressive Agents - therapeutic use; Infant, Newborn; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - drug therapy; Lupus nephritis; Medical treatment; Medicine; Medicine & Public Health; pre-eclampsia; Pre-Eclampsia - diagnosis; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Renal Insufficiency - diagnosis; Renal Insufficiency - etiology; Rheumatology; Systemic lupus erythematosus; Treatment Outcome; Systemic lupus erythematosus; Congestive heart failure; Lupus nephritis; Preeclampsia
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-008-1061-3

We report the case of a 26-year-old woman with severe renal and congestive heart failure as a primary manifestation of systemic lupus erythematosus after her premature terminated pregnancy for the symptoms of preeclampsia with HELLP syndrome. Preeclampsia, due to the similarity with SLE in many signs and symptoms, delayed the diagnosis. The importance of the renal biopsy that helped us to make a differential diagnosis in a patient with an unclear proteinuria persisting postpartum is obvious. We suggest that a diagnostic algorithm of patients suffering from preeclampsia should exclude SLE since only an early and adequate treatment can prevent irreversible organ impairment.