Сase of neonatal lupus in one of two children of dichorial diamniotic pregnancy in a woman with unrecognized systemic lupus erythematosus and lupus nephritis

Abstract

The ability to realize the reproductive function for both patients with systemic lupus erythematosus and patients with a different cause of chronic kidney disease is rightfully considered as one of the most important achievements of modern medicine. The work describes the pregnancy case of the patient with systemic lupus erythematosus and secondary antiphospholipid syndrome. Renal damage with the development of renal thrombotic microangiopathy came to the fore in the clinical picture, which was regarded as nephritis and complicated the diagnosis of systemic lupus erythematosus. A positive pregnancy outcome was achieved with the development of neonatal lupus erythematosus in one twin child. The options for the prevention and treatment of thrombotic complications as well as methods for minimizing gestational complications (including preeclampsia, which the patient had in history) are discussed, inter alia, with the purposed of low-molecular-weight heparins and acetylsalicylic acid preparations. Treatment options are also described to improve the outcome of such pregnancies and to decrease the symptoms of neonatal lupus erythematosus using hydroxychloroquine. The article summarizes current management approaches for these patients with special attention to the interdisciplinary approach.