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- W3155119785 abstract "Objective: Systemic lupus erythematosus belongs to the group of autoimmune disorders which can affect multiple organ systems of the body during its chronic course. It is commonly associated with cardiac manifestations. The characteristic abnormalities among cardiac lesions include Libman- Sacks endocarditis and pericarditis, while myocarditis is relatively uncommon. Among valvular lesions, the most common complication is mitral valve regurgitation. Design and method: A 27 year old lady with systemic lupus erythematosus, on treatment since 1 year, was referred to our hospital with the suspicion of development of Lupus nephritis and tubercular pleural effusion. She was started on anti-tubercular therapy based on the pleural fluid analysis. As tuberculosis is prevalent in our country and her pleural fluid showed raised adenosine deaminase levels, anti-tubercular therapy was modified for renal safety but continued. Her previous reports showed the presence of subnephrotic proteinuria in urine for 6 months. She presented to the emergency department with complaints of breathlessness and chest discomfort. Her initial blood workup revealed new-onset derangement in renal parameters. Lupus nephritis was suspected. Results: She developed a worsening of breathlessness and was shifted to the ICU. She was given intravenous pulse steroids and monitored. Her renal dysfunction improved. She developed paroxysmal nocturnal dyspnoea with persistent tachycardia and tachypnea. A trans-thoracic echocardiogram was done which revealed a massive loculated pericardial effusion. She was conservatively managed and then shifted to the ward. After a few days, she developed sudden onset pulmonary edema and was shifted back to the ICU. Echocardiogram was repeated which showed new-onset acute severe mitral regurgitation with central jet. The patient was medically managed. Her symptoms improved and she was initiated on mycophenolate mofetil and discharged. Two months later she was admitted for renal biopsy. Lupus nephritis was confirmed. She is now on regular follow-up with significant clinical improvement.Conclusions: Systemic Lupus Erythematosus can involve multiple organ systems rapidly and simultaneously with a predisposition to developing other infections. This increases the risk of morbidity and mortality. Early diagnosis and timely initiation of therapy are essential in improving the survival outcomes of the patient." @default.
- W3155119785 created "2021-04-26" @default.
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- W3155119785 date "2021-04-01" @default.
- W3155119785 modified "2023-09-25" @default.
- W3155119785 title "AN UNUSUAL CASE OF ACUTE MITRAL REGURGITATION WITH LUPUS NEPHRITIS AND EXTRA PULMONARY TUBERCULOSIS" @default.
- W3155119785 doi "https://doi.org/10.1097/01.hjh.0000746592.31510.b9" @default.
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