关键词: 神经精神性系统性红斑狼疮, 红斑狼疮, 系统性, 癫痫, 妊娠, 自身免疫疾病, 甲泼尼龙

Abstract:

The patient was a female of childbearing age. She had a seizure in late pregnancy during sleep without any obvious trigger and with unconscious during the seizure, awakening on her own after a few minutes, but felt dizzy and had a headache and was admitted to the hospital as an emergency. This patient had a history of systemic lupus erythematosus, antiphospholipid syndrome, hypertension, deep vein thrombosis of the lower extremities, and disfavorable pregnancies(such as intrauterine fetal death, spontaneous abortion). Gestational diabetes mellitus was present in this pregnancy. Her mother has a history of epileptic seizures. The patient′s vital signs were stable and she has not had a seizure since admission. We performed the relevant ancillary examinations and multi-disciplinary treatment. We considered the patient′s diagnosis of neuropsychiatric systemic lupus erythematosus and treated her with high-dose methylprednisolone and therapeutic doses of low molecular heparin, and dexamethasone to promote fetal lung maturation. We performed a cesarean section under general anesthesia at 33⁺³ weeks of the patient′s gestation and the operation was successful. She delivered a female infant weighing 1 810 g and the infant′s 1 min, 5 min Apgar score were 10-10. The preterm baby was transferred to the neonatal unit for treatment, and the mother was discharged seven days after surgery and presented to the specialist four months later. The prognosis for both mother and daughter was favorable.

Key words: Neuropsychiatric systemic lupus erythematosus, Lupus erythematosus, systemic, Epilepsy, Pregnancy, Autoimmune diseases, Methylprednisolone