Systemic lupus erythematosus and secondary antiphospholipid syndrome in native sisters with reduced fertility
Abstract
Objective: Systemic lupus erythematosus (SLE) and secondary anti-phospholipid syndrome (APS II) can cause increased morbidity and mortality of the fetus. We followed the course of fertility of two sisters with these two basic diseases.
Methods: In the Center for Immunology of Reproduction, we confirmed both sisters had increased levels of some selected anti-phospholipid antibodies (against phosphatidylserine, phosphatidyl-ethanolamine, phosphatidylinositol, DL-glycerole, anexin V, phoshatidic acid, cardiolipin, beta2-glycoprotein I), anti-nuclear, and anti-DNA antibodies. During the established immunosuppressive and hormonal therapy at the time of SLE remission, both sisters became pregnant.
There was a physiological progression of pregnancy until the 19th week. Results: At the 20th week of pregnancy, the older sister miscarried again, and the younger sister developed hypertension in the 31st week of pregnancy which was terminated by caesarean section.
Conclusion: In our causal evaluation, we addressed two serious autoimmune diseases (SLE, APS II) in two sisters and described their course of pregnancy. However, only one of them became a happy mother.