{
  "abstract": "Objectives SLE and APS are autoimmune disorders that may first manifest during pregnancy or the postpartum period, often mimicking obstetric complication such as preeclampsia. The aim of this case study is to emphasize that early recognition is crucial to prevent maternal and fetal morbidity.Methods A 26-year-old Caucasian woman presented with moderate-to-severe left knee pain. No other joint complains, no other objective signs at inspections, beside mild malar rash. She had a baby two months before, after 2 miscarriage and she referred a very problematic third trimester resulting with hospitalization for preeclampsia followed with cesarean section at 31 weeks. During 15 days prior to delivery she had prednisolone in her daily therapy for joint pain, which started recently.After delivery her proteinuria was improved and her blood pressure normalized gradually. Prednisolone was on therapy till the last day. She was discharged on postoperative day 7. She was planed for a cardiology consultation only.One week after discharge she was send from home to emergency because she had a very difficulty in breathing . After the initial tests there was performed a CT pulmonary angiogram and a cardiac ultrasoud. She was admitted in cardiology. In her discharge paper from cardiology she was diagnosed as peripartum cardiomyopathy(PPCM) and she was currently on therapy as cardiology recommended.Results Considering patient anamnesis beside the basic check up test, specific immunology test were asked and which resulted: ANA positive(1/320), RF negative, ENA total positive( 6.9), Anti-dsDNA positive(112 U/ml), ENA SS-A positive(over 200 U/ml), Anti phospholipid IgG positive(21 GPL-U/ml), Anti phospholipid IgM positive(20.30 MPL-U/ml), C3 73 mg/dl(low), C4 5.4 mg/dl(low). Also ESR 61 mm/h, HGB 11g/dl and mild proteinuria.The diagnosis SLE with APS was estabilished and the therapy was prescribed immediately.Conclusions This case highlights the diagnostic challenges of differentiating autoimmune disease flares from pregnancy-related complications.SLE can mimic preeclampsia and cardiomyopathy in the peripartum period, potentially delaying appropriate management and diagnosis.Multidisciplinary assessment and autoimmune screening should be considered in atypical or refractory cases to determine the diagnosis and treatment.Always consider rheumatology consultation in articular inflammatory pain in peripartum period.",
  "authors": [
    {
      "affiliations": [
        "UHC Mother Teresa,Department of Rheumatology, Tirana, Albania"
      ],
      "name": "Valbona Salko"
    },
    {
      "affiliations": [
        "UHC Mother Teresa,Department of Rheumatology, Tirana, Albania"
      ],
      "name": "Artur Zoto"
    },
    {
      "affiliations": [
        "UHC Mother Teresa,Department of Rheumatology, Tirana, Albania"
      ],
      "name": "Ervin Rapushi"
    }
  ],
  "title": "PO:04:102 From knee pain to systemic lupus erythematosus(SLE) with antiphospholipid syndrome(APS) .A New-onset SLE misdiagnosed as preeclampsia in third trimester",
  "uid": "df95960a-e588-5207-95b0-e908e504f90f"
}