Aoki Shigeru, Mochimaru Aya, Yamamoto Yuriko, Kurasawa Kentaro, Takahashi Tsuneo, Hirahara Fumiki
Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center , Yokohama , Japan.
Mod Rheumatol. 2015 May;25(3):410-4. doi: 10.3109/14397595.2014.979522.
Systemic lupus erythematosus (SLE) flare and preeclampsia are difficult to differentiate from each other and occasionally coexist; This study aimed to analyze cases requiring termination of pregnancy due to SLE flare or preeclampsia and to elucidate the association between these two conditions; Methods. Out of 71 pregnancies in 60 women managed for SLE-complicated pregnancies who delivered at or after 22 weeks' gestation at a tertiary center, 7 pregnancies were terminated due to uncontrollable severe SLE flare or severe preeclampsia We retrospectively analyzed the clinical courses and laboratory findings of these 7 cases to determine whether their pathological conditions were attributable to SLE flare alone, preeclampsia alone, or the coexistence of these two conditions.
One of the 7 cases had preeclampsia alone, two had SLE alone, and four had both conditions. The coexistence of preeclampsia and SLE was thus the most common condition. In cases with both conditions, SLE flare had preceded preeclampsia, thereby making treatment after delivery difficult.
Severe SLE flare often preceded severe preeclampsia and worsened after delivery. When differentiating severe SLE flare from severe preeclampsia is difficult during pregnancy, women should be regarded as having SLE flare rather than preeclampsia and aggressively treated.
系统性红斑狼疮(SLE)病情发作与子痫前期难以相互区分,且偶尔会同时存在;本研究旨在分析因SLE病情发作或子痫前期而需要终止妊娠的病例,并阐明这两种情况之间的关联;方法。在一家三级中心接受治疗的60例SLE合并妊娠且妊娠22周及以后分娩的妇女的71次妊娠中,有7次妊娠因无法控制的严重SLE病情发作或严重子痫前期而终止。我们回顾性分析了这7例病例的临床病程和实验室检查结果,以确定其病理状况是仅归因于SLE病情发作、仅归因于子痫前期,还是这两种情况同时存在。
7例病例中,1例仅有子痫前期,2例仅有SLE,4例两种情况都有。因此,子痫前期和SLE同时存在是最常见的情况。在两种情况都有的病例中,SLE病情发作先于子痫前期,从而使产后治疗变得困难。
严重SLE病情发作常先于严重子痫前期,并在产后恶化。当孕期难以区分严重SLE病情发作与严重子痫前期时,应将女性视为患有SLE病情发作而非子痫前期,并积极进行治疗。