Humala Alexander Indra, Wardhana Manggala Pasca
Department of Obstetrics and Gynecology, Faculty of Medicine, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Case Rep Womens Health. 2024 Nov 6;44:e00662. doi: 10.1016/j.crwh.2024.e00662. eCollection 2024 Dec.
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease. Pericarditis in SLE can lead to severe effusion and cardiac tamponade, and is associated with significant morbidity and mortality. Therefore, early diagnosis and treatment are essential. A 32-year-old woman at 21 weeks of gestation with a history of lupus pericarditis two years previously presented to the emergency department with shortness of breath, fever, and weakness. Transthoracic echocardiography revealed a massive pericardial effusion, right ventricle failure, pulmonary hypertension, severe tricuspid regurgitation, and mild mitral regurgitation. A chest X-ray suggested pericardial effusion accompanied by pulmonary edema. Due to worsening of the patient's health, a joint decision was made with her and her family to terminate the pregnancy. Most cardiac manifestations of SLE worsen during pregnancy and can lead to life-threatening conditions such as cardiac tamponade or congestive heart failure. This is a rare case of recurrent lupus pericarditis in pregnancy accompanied by massive pericardial effusion, heart failure and pulmonary edema. Management is challenging because the most effective drugs are known to be harmful to the fetus.
系统性红斑狼疮（SLE）是一种自身免疫性多系统疾病。SLE中的心包炎可导致严重积液和心脏压塞，并与显著的发病率和死亡率相关。因此，早期诊断和治疗至关重要。一名32岁女性，孕21周，两年前有狼疮性心包炎病史，因呼吸急促、发热和乏力就诊于急诊科。经胸超声心动图显示大量心包积液、右心室衰竭、肺动脉高压、严重三尖瓣反流和轻度二尖瓣反流。胸部X线提示心包积液伴肺水肿。由于患者健康状况恶化，与她及其家人共同决定终止妊娠。SLE的大多数心脏表现会在孕期加重，并可导致危及生命的情况，如心脏压塞或充血性心力衰竭。这是一例罕见的妊娠复发性狼疮性心包炎伴大量心包积液、心力衰竭和肺水肿的病例。管理具有挑战性，因为已知最有效的药物对胎儿有害。
