Diagnosis and Management of Systemic Lupus Erythematosus: A Case Report

Abstract

Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease with a broad clinical presentation, which is principally difficult to diagnose across the emergency departments (EDs). The immune system of the body in this disease mistakenly damages or attacks healthy tissues. Majority of the patients suffering from SLE tend to develop "secondary heart disease" once in a while throughout the course of their primary illness. This study aimed to report a case of a previously healthy 9-year-old Saudi female who presented with rheumatic fever and congestive heart failure accompanied by productive cough, chest, abdomen, and back pain. A 9-year-old Saudi female was presented to the emergency department with a history of progressive rheumatic fever, iron deficiency anemia, and pain in chest with productive cough. Examination revealed that patient felt extremely ill, pale, afebrile, with a loss of appetite, tachycardic, high grade fever (39 °C), tachypneic, and a peripheral oxygen saturation of 95% on 40% supplemented oxygen" with low blood pressure 105/70 was noted. The patient was assumed to be diagnosed with probable SLE. We started our patient on methylprednisolone, omeprazole, and prednisolon and noticed sustained improvements. Multisystemic and acute life-threatening conditions should arise the suspicion of autoimmune diseases, predominantly SLE in the ED. SLE treatment shall be planned separately with consideration to utilize the "best-suited therapy" for targeting the organ systems affected. Lack of an explicit biological marker, disease heterogeneity, as well as absence of a specific outcome measurement for improvement makes this procedure harder.