Abstract
Introduction This is a case of new-onset systemic lupus erythematosus (SLE) manifesting as acute pneumonitis during pregnancy. No prior reports have documented pneumonitis as the presenting manifestation of SLE in pregnant women. Case Presentation. A 23-year-old pregnant female presented with high-grade fever, cough, arthralgias, and respiratory failure. Infectious workup was negative. She was positive for ANA, anti-dsDNA, anti-SSA, hypocomplementemia, and pulmonary infiltrates, supporting the diagnosis of SLE and pneumonitis. The patient received methylprednisolone achieving adequate clinical and serological response. Conclusion When SLE patients present with fever, cough, and respiratory failure, pulmonary infiltrates should raise the suspicion of pneumonitis in the absence of infection and hemorrhage. Even though acute lupus pneumonitis (ALP) is rare and seen only in 2% of SLE patients, a high index of suspicion aids in prompt diagnosis of this life-threatening condition. Also, positive anti-SSA antibodies may be associated with lupus pneumonitis.
Highlights
We report a rare case of a young female diagnosed with newonset systemic lupus erythematosus (SLE) during her pregnancy, manifested as acute lupus pneumonitis (ALP)
We report a rare case of a young female diagnosed with newonset SLE during her pregnancy, manifested as acute lupus pneumonitis (ALP)
CTchest was not pursued, given the risk of radiation exposure in pregnancy. She never developed hemoptysis or significant drop in hemoglobin to favor of alveolar hemorrhage. e patient was diagnosed with new-onset SLE as per the EULAR/ACR 2019 criteria as she presented with fever, leukopenia, arthritis, pneumonitis, low complements, and positive serological lupus studies (ANA and anti-dsDNA). She was started on hydroxychloroquine 200 mg twice daily, and intravenous corticosteroids were switched to oral prednisone on the fourth day of IV methylprednisolone. is achieved adequate clinical and serological response as her C-reactive protein (CRP), hypocomplementemia, and pancytopenia significantly improved within 5 days
Summary
We report a rare case of a young female diagnosed with newonset SLE during her pregnancy, manifested as acute lupus pneumonitis (ALP). ALP is a life-threatening and uncommon manifestation of SLE that requires prompt diagnosis and treatment. Ere are no case reports in the literature documenting pneumonitis as the presenting manifestation of SLE in pregnant population ALP is a life-threatening and uncommon manifestation of SLE that requires prompt diagnosis and treatment. ere are no case reports in the literature documenting pneumonitis as the presenting manifestation of SLE in pregnant population
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