DefinePK

Abstract

Woman pregnancy with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) is a rare case. An Indonesian woman pregnancy, 29 years old, complained of right-sided chest pain, cough, short breath, melena, and joint discomfort. She has had two abortions in the past 2 years. The patient previously had anemia with hemoglobin of 5 mg/dL and received 4x PRC transfusions. Echocardiography and chest CT scan with contrast revealed a right ventricle thrombus. Laboratory examination presented with APS and suspected autoimmune hemolytic anemia (AIHA). Patient received PCR transfusion of 250 mL twice daily with initially dexamethasone of 5 mg at admission, lansoprazole of 30 mg twice daily, Sucralfate of 15 mL thrice daily, Methylprednisolone of 8 mg once daily, Hydroxychloroquine 200 mg once daily, Enoxaparin of 0.6 mL twice daily, and acetylsalicylic acid of 80 mg once day. After treatment, she had an improved Hb of 10.3 g/dL and was discharged. Despite clinical improvement, she had a third abortion. The challenge in APS Management is to increase fetal and maternal growth and prevent thrombus formation with close monitoring of anticoagulant use. Patients who experience recurrent abortions need to be considered for APS and/or SLE possibility