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New-onset systemic lupus erythematosus during pregnancy

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Abstract

Few studies have been published focusing on the clinical features of new-onset systemic lupus erythematosus (SLE) during pregnancy. This study examined the clinical characteristics of SLE during pregnancy or puerperium. The clinical characteristics and serological parameters of 48 patients with onset of SLE during pregnancy were retrospectively compared with those of age-matched new-onset SLE patients who were diagnosed in a period of more than 12 months without pregnancy (n = 65) and age-matched preeclampsia patients (n = 48). SLE tended to occur during the first and second trimesters (33 and 42 %, respectively). Lupus nephritis (LN) and severe thrombocytopenia were more commonly seen in new-onset SLE during pregnancy than in patients without pregnancy (68.8 vs 35.4 % and 25 vs 9.2 %, respectively, p < 0.05). However, pregnant patients had lower frequency of fever, arthritis, arthralgia, alopecia, oral ulcer, and hypocomplementemia than the nonpregnant controls (p < 0.05). Compared to LN patients without pregnancy (n = 23), LN patients with pregnancy (n = 33) had more prominent proteinuria and nephrotic syndrome (p < 0.05). On the other hand, when compared to patients with preeclampsia, patients with new-onset SLE during pregnancy had early onset of symptoms during gestation and were characterized by presence of fever, malar lesion, autoantibodies, hypocomplementemia, hyperuricemia, active urinary sediment, and multi-organ involvement. In conclusion, patients with their first onset of lupus during pregnancy generally have more severe disease with higher prevalence of renal and platelet involvement.

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Acknowledgments

This project was supported by a grant from the National Natural Science Foundation (81273278), grants from the Natural Science Foundation of Guangdong Sciences Committee (s2011010004578 and S2012010008780), and a grant from the Guangzhou Science and Technology program (2012 J4100085).

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Authors and Affiliations

  1. Department of Rheumatolgoy, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, People’s Republic of China

    Chunmei Zhao, Jijun Zhao, Hongyue Wang, Hui Zhang, Hanshi Xu & Niansheng Yang

  2. Department of Pediatrics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Yuefang Huang

  3. Department of Obstetrics & Gynecology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Zilian Wang

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  1. Chunmei Zhao
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  5. Hongyue Wang
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Correspondence to Niansheng Yang.

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Zhao, C., Zhao, J., Huang, Y. et al. New-onset systemic lupus erythematosus during pregnancy. Clin Rheumatol 32, 815–822 (2013). https://doi.org/10.1007/s10067-013-2180-z

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  • DOI: https://doi.org/10.1007/s10067-013-2180-z

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