Журнал клинических случаев

Acute Systemic Lupus Erythematosus and Antiphospholipid Syndrome with Miscarriage

Abstract

Asieh Aref, Mohsen Maleknia, Mohammad Sakiani, Hashem Kazemi and Zahra Shahpouri Aarani*

Background: Antiphospholipid syndrome is an autoimmune, hypercoagulable state that is caused by antiphospholipid antibodies. Anticardiolipin antibodies, anti-b2 glycoprotein-I, and lupus anticoagulants are the main autoantibodies found in antiphospholipid syndrome. In this brief communication, we describe the case of a woman who has been suffering from treatment-resistant and difficult to manage bipolar disorder (BPD) with fluctuating thrombocytopenia and neurological findings with positive lupus anticoagulant. This was important because it was a multicomplicated problem and showed antiphospholipid syndrome with lupus. We propose it to be a consequence of an atypical presentation of APS.

Case presentation: The known case of APS (antiphospholipid syndrome) and SLE (systemic lupus erythematous) with a history of kidney transplantation for 14 years, infertility, and CVA (cerebrovascular accident). According to the history of infertility, she had an abortion. Lab data reveals a positive anticoagulant antibody. The microscopy pathology data showed mainly necrotic chorionic villi admixed with extensive hemorrhage and evidence of thrombosis.

Conclusion: This is the report of APS with SLE (systemic lupus erythematosus) and miscarriage. Patients with menopausal history and a history of infertility should also be considered for fertility.