Presentation of systemic lupus erythematosus (SLE) in emergency department: a case report

Fernandes, Natália; Gomes, Guilherme; Capela, Carlos
June 2013
BMC Research Notes;2013, Vol. 6 Issue 1, p1
Academic Journal
Background: Abrupt and life-threatening presentations in connective tissue diseases (CTD) are rarely reported. Their early recognition and specific management could change course disease. SLE is a multisystem inflammatory disease that is often difficult to diagnose in the emergency department (ED). Case presentation: A 26-year-old woman presented to the ED with a 48 hour history of progressive dispnea, generalized edema and left lower chest pain with non-productive cough. On examination, patient was feeling very ill, afebrile, tachycardic, tachypneic and a peripheral oxygen saturation of 94% on 40% supplemented oxygen with raised jugular venous pressure was noted. Intermittently, she presented an obtunded state of consciousness. A large pericardial, pleural and abdominal effusion was confirmed and a broad differential diagnosis was made. The patient had a 6 months history of inflammatory polyarthralgias involving initially interphalangeal joints, evolving, sometime later, the knees and elbows bilaterally and she was started glucocorticoids. 12 days before admission, she had had symptoms of a urethritis episode. In the context of an immunosupressed patient, with initial focal urologic complains, evidence of multiorgan dysfunction and a picture resembling a distributive shock, dictated a low threshold for sepsis. Conclusions: Separating an acute episode of SLE from sepsis, on emergency grounds, can even be the most challenging decision. In the ED, acute life-threatening and multisystemic conditions should arise the suspicion of autoimmune diseases, particularly SLE


Related Articles

  • Viral Syndrome--or Lupus?  // Clinician Reviews;Feb2009, Vol. 19 Issue 2, p8 

    This article discusses a malpractice lawsuit filed against a hospital emergency department (ED) for the death of a 34-year-old woman with systemic lupus erythematosus. The patient experienced chills, fever and blood in her urine. The day following her ED visit, the patient suffered a grand mal...

  • Prevalence of autoantibodies against structure specific recognition protein 1 in systemic lupus erythematosus. Fineschi, S.; Borghi, M.O.; Riboldi, P.; Gariglio, M.; Buzio, C.; Landolfo, S.; Cebecauer, L.; Tuchynova, A.; Rovensky, J.; Meroni, P.L. // Lupus;2004, Vol. 13 Issue 6, p463 

    Antibodies (Abs) against the structure specific recognition protein 1 (SSRP1) were reported in a small systemic lupus erythematosus (SLE) series but not in other systemic autoimmune diseases. The aim of the study was to confirm the selective presence of anti-SSRP1 Abs in a larger SLE series and...

  • Fine specificity of the Ro/SSA autoantibody response in relation to serological and clinical findings in 96 patients with self-reported cutaneous symptoms induced by the sun. Popovic, K.; Brauner, S.; Ek, M.; Wahren-Herlenius, M.; Nyberg, F. // Lupus;2007, Vol. 16 Issue 1, p10 

    Anti-Ro/SSA assays assist the clinician in distinguishing autoimmune diseases such as Sj�gren's syndrome (SS), systemic lupus erythematosus (SLE) and subacute cutaneous lupus erythematosus (SCLE). The objective of the study was to investigate the fine specificity of the autoantibodies in...

  • Anti-malarials and Lupus in West Africa use and lupus in Africans. Westlake, S. L.; Edwards, C. J. // Lupus;Mar2009, Vol. 18 Issue 3, p193 

    The author reflects on the existence of anti-malarials and lupus in West Africa. He mentions that the highest prevalence and greatest severity of disease is seen in individuals with African and Afro-Caribbean ethnic backgrounds resident in North America or Europe. He notes that systemic lupus...

  • Association between the CD226 rs763361 polymorphism and susceptibility to autoimmune diseases: a meta-analysis. Song, GG; Bae, S-C; Choi, SJ; Ji, JD; Lee, YH // Lupus;Dec2012, Vol. 21 Issue 14, p1522 

    Objective: The aim of this study was to explore whether the CD226 rs763361 polymorphism confers susceptibility to autoimmune diseases. Methods: A meta-analysis was conducted on the associations between the CD226 rs763361 polymorphism and autoimmune diseases using: 1) allele contrast, and 2) the...

  • Autoimmune disorders associated with NHL risk. Jacob, Harry S. // Hem/Onc Today;5/10/2008, Vol. 9 Issue 8, p38 

    The article talks about the relationship between autoimmune disorders and non-Hodgkin's lymphoma (NHL) risk. It details that autoimmune disorders such as Sjögren syndrome and systemic lupus erythematosus (SLE) are related to the increased risk of a person having NHL. Involvement of patients...

  • FcgammaRIIB in autoimmunity and infection: evolutionary and therapeutic implications. Smith, Kenneth G. C.; Clatworthy, Menna R. // Nature Reviews Immunology;May2010, Vol. 10 Issue 5, p328 

    FcgammaRIIB is the only inhibitory Fc receptor. It controls many aspects of immune and inflammatory responses, and variation in the gene encoding this protein has long been associated with susceptibility to autoimmune disease, particularly systemic lupus erythematosus (SLE). FcgammaRIIB is also...

  • Clinical and immunological manifestations in 151 SLE patients living in Dubai. AlSaleh, J.; Jassim, V.; ElSayed, M.; Saleh, N.; Harb, D. // Lupus;2008, Vol. 17 Issue 1, p62 

    To gain better understanding of systemic lupus erythematosus (SLE) in Dubai we studied the clinical and immunological manifestations in a cohort of 151 patients attended Rheumatology Clinic in Dubai Hospital between January 2002 and January 2007. We found that the female to male ratio was...

  • Autoimmune hepatitis in a patient with systemic lupus erythematosus. Iwai, M.; Harada, Y.; Ishii, M.; Tanaka, S.; Muramatsu, A.; Mori, T.; Nakashima, T.; Okanoue, T.; Hirohata, S. // Clinical Rheumatology;Sep2003, Vol. 22 Issue 3, p234 

    We report a female patient with systemic lupus erythematous (SLE), hyperbilirubinemia and high serum value of ALT. International autoimmune hepatitis (AIH) score showed definite AIH before treatment, but autoantibodies could not make a differential diagnosis of AIH and SLE-associated hepatitis....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics