Severe pulmonary arterial hypertension and massive ascites in a patient with systemic lupus erythematosus and secondary Sjogren's syndrome

Lupus. 2021 Mar;30(3):510-513. doi: 10.1177/0961203320976982. Epub 2020 Dec 1.

Abstract

Background: Pulmonary arterial hypertension (PAH), is a rare manifestation of systemic lupus erythematosus (SLE), characterized by pulmonary arterial remodeling leading to right ventricular failure and death. To date, optimal management of SLE-associated PAH should be clarified, especially regarding the respective places of immunosuppressants and PAH vasodilator treatments.

Case report: We report the case of a 48-year-old woman with SLE and secondary Sjogren syndrome, associated with severe PAH and lupus peritonitis with massive ascites, who showed a remarkable response, both for SLE flare and PAH, to a treatment combining immunosuppressants and pulmonary arterial vasodilator treatment.

Conclusion: This observation highlights the interest of combining immunosuppressive therapy in SLE-PAH, whose modalities in association with PAH treatments should be clarified.

Keywords: Systemic lupus erythematosus; ascites; lupus peritonitis; pulmonary arterial hypertension.

Publication types

  • Case Reports

MeSH terms

  • Ascites / etiology
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy*
  • Middle Aged
  • Pulmonary Arterial Hypertension / drug therapy*
  • Pulmonary Arterial Hypertension / etiology
  • Sjogren's Syndrome / complications
  • Vasodilator Agents / therapeutic use*

Substances

  • Immunosuppressive Agents
  • Vasodilator Agents