ESPN 50th Annual Meeting

ESPN 2017


 
MISDIAGNOSE OF SYSTEMIC LUPUS ERYTHEMATOSUS AFTER CHILDHOOD THROMBOCYTOPENIA, RESULTED WITH CHOREA MANIFESTATION DURING PREGNANCY- TREATED SUCCESSFULLY WITH NO APPARENT ADVERSE EFFECTS ON FETAL GROWTH.
VALBONA STAVILECI 1 DIAMANT SHTIZA 2 IRENA PALLOSHI 2 ARLINDA MALOKU 1 MERGIME BATUSHA 1 ARBNORE BATALLI 1 PRANVERA GJYSHINCA 1

1- UNIVERSITY CLININCAL CENTER OF KOSOVA
2- UNIVERSITY CLINICAL CENTER OF TIRANA
 
Introduction:

Idiopathic Thrombocytopenia is associated with LES, but ANA and LEcells may not be positive during early childhood. Alike, Chorea gravidarum, can be caused by other systemic collagen diseases, as (SLE)

 

Material and methods:

We report a case of chorea gravidarum caused by SLE. This case during early childhood by age of 8, presented with Idiopatic Trombocytopenia but ANA and LE cells, were negative at presentation. Bone biopsy resulted: immune trombocitopenia. Treated by Prednisone tbl.4mg. By age of 16teen she had hand-palm pain and was diagnosed as Arthritis and no specific treatment. Her first pregnancy with no problems.Second pregnancy age 25, had Blood pressure PA: 140/90 mmHg. By 25 gestational weeks she presented with uncontrolled choreiform movements of the hands, body and head, diagnosed Chorea gravidarum.Treated with Haldol tbl. 10weeks.

Results:

Because of a positive autoimmune history, she was examined for LES and resulted with active disease and all Antibodies positive Anti DNA IgG, Anti ds DNA; C3, C4, CH50: decreased); CCP: neg;. Brain  MRI (twice): acute ischemic lesions-microinfacts, also Glial zones corresponds to lacunar chronic ischemic lesions of vascular ethiology, suspicious as thrombotic complications. Abdominal Ultrasound findings within normal. Proteinuria: 500mg/24h. Fetal growth on ultrasonography was normal. A female infant, normal weight 38 gw.

Conclusions:

Misdiagnose of LES at time and as a consequence, a new trigger initiated symptoms of active Cerebral LES manifestation with Chorea. Even during pregnancy is treatable and with no consequences to fetal growth and pregnancy outcomes. Criteria for thrombocytopenia fellow up should be set, to prevent complication of LES