HCA Florida Northwest Hospital
Lupus, SLE, autoimmune dieases
Immune System Diseases | Internal Medicine | Medicine and Health Sciences
Systemic Lupus Erythematosus (SLE) is a multifactorial autoimmune disease that is capable of involving almost any organ in the body, leading to significant morbidity and mortality in affected patients. SLE is characterized by pathogenic autoantibodies that react with antigens and form immune complexes, resulting in tissue damage and a potential wide array of manifestations, including arthralgias, lupus nephritis, pleuritis, and delirium. Experts cite the effect of estrogens or factors related to the X chromosome as possible explanations regarding the increased prevalence of SLE in women over men, with ratios of up to 15:1. Here, we discuss the case of a 36-year-old male patient with a history of SLE who presented to the emergency department for worsening fatigue, nausea, and vomiting. On admission, the patient was found to have a pericardial effusion, pleural effusion, ascites, and acute renal failure. During his first day of stay at the hospital, the patient suffered a cardiac arrest, requiring endotracheal intubation, emergent pericardiocentesis, thoracentesis with drainage of 1.5 liters of pleural fluid, and paracentesis with drainage of 1.5 liters of peritoneal fluid. Interdisciplinary efforts from the ICU, IM, cardiology, pulmonology, cardiothoracic surgery, nephrology, infectious disease, neurology, IR, and pain management teams were vital in returning this patient to baseline functional status over the course of a long, complicated hospital stay. Through this case, we highlight the various, severe complications SLE is capable of inflicting upon the body, with a particular focus directed towards the rare but more critical presentation males with SLE may adopt. Additionally, we emphasize the role of public health and insurance status in the prognosis of patients with SLE, as our patient’s inability to adhere to outpatient medical therapy undoubtedly played a contributory role to his acute decompensation and near-fatal outcome.
Ali, Aleeza; Kaito, Max; Dennison, Stanley; Zisling, Hanan; Khalifa, Esam; and Romano, John, "Severe Case of Systemic Lupus Erythematosus in a 36-year-old Male" (2023). East Florida Research Day 2023. 24.