一名患有系统性红斑狼疮和心脏压塞的印度尼西亚孕妇：病例报告。
An Indonesian pregnant woman with systemic lupus erythematosus and cardiac tamponade: A case report.
作者信息
Felani Resa
机构信息
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
出版信息
Int J Surg Case Rep. 2022 May;94:107159. doi: 10.1016/j.ijscr.2022.107159. Epub 2022 May 4.
BACKGROUND
Systemic lupus erythematosus (SLE) during pregnancy with cardiac tamponade is a rare case.
CASE PRESENTATION
A 33-year-old pregnant woman complained of worsening shortness of breath, hair loss, and joint pain. Laboratory investigation revealed the poor condition of the patient so therapeutic abortion was recommended. Transthoracic echocardiography confirmed cardiac tamponade and pericardiocentesis was performed. The ANA test showed a flare SLE and she was given immunosuppressant therapy. Repeat echocardiography demonstrated minimal pericardial effusion. The patient refused cyclophosphamide. Follow-up echocardiography evaluation at fifth-month revealed minimal pericardial effusion. However, patient refused to be hospitalized.
DISCUSSION
A combination of pericardiocentesis and immunosuppressant therapy is an effective strategy to treat cardiac tamponade in pregnancy with SLE.
CONCLUSION
Immunosuppressants and pericardiocentesis followed by cyclophosphamide are the cornerstones of management of SLE and cardiac tamponade in pregnant patients.
背景
妊娠期间系统性红斑狼疮（SLE）合并心脏压塞是一种罕见病例。
病例报告
一名33岁孕妇主诉呼吸急促、脱发和关节疼痛加重。实验室检查显示患者病情不佳，因此建议进行治疗性流产。经胸超声心动图证实存在心脏压塞，并进行了心包穿刺术。抗核抗体检测显示SLE病情活动，给予免疫抑制治疗。重复超声心动图显示心包积液极少。患者拒绝使用环磷酰胺。第五个月的超声心动图随访评估显示心包积液极少。然而，患者拒绝住院。
讨论
心包穿刺术和免疫抑制治疗相结合是治疗妊娠合并SLE心脏压塞的有效策略。
结论
免疫抑制剂、心包穿刺术随后使用环磷酰胺是妊娠合并SLE和心脏压塞管理的基石。
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