SLE / STUDY CASES

Question 1

Pre-pregnancy counseling :
Woman with SLE - [ diagnosis based on: * double standard DNA antibodies +* renal biopsy shows stage 4 lupus nephritis now:
Urine: protein ++
What further investigation required?

Answer 1

1- level of proteinuria
2- protein: cr ratio
3- glomerular filtration rate eGFR
4- disease markers C3 C4
5- antiphospholipid antibodies
6- antiRo/La

Question 2

Woman with SLE - [ diagnosis based on: * double standard DNA antibodies +* renal biopsy shows stage 4 lupus nephritis [5y ago]
now: she is on medications
Urine: protein ++
What pregnancy complications are more common?

Answer 2

Maternal : hypertension + PET
Fetal: FGR / still B /

Question 3

Woman with SLE pre pregnancy
Now she is taking :
Prednisolone + hydrxychloroquine
+candesartan + simvastatin +fe + vitD
What is the alteration of treatment during pregnancy?

Answer 3

1- Candesartan 👉 methyldopa or labetalol
2- continue: prednisolone + hydroxychloroquine
3- add folic acid 5 mg
4- add ASPIRIN once viable pregnancy is confirmed