Reproductive Environment in Patients with SLE
By María del Carmen Zamora Medina, Andrea Hinojosa Azaola, Carlos A. Núñez Alvarez, Angel Gabriel Vargas Ruiz and Juanita Romero Díaz
Submitted: December 12th 2018
Reviewed: February 22nd 2019
Published: April 9th 2019
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This Article in Multisystemic Autoimmune Disorder was written along with my fellowmates Andrea Hinojosa Azaola, Carlos A. Núñez Alvarez, Angel Gabriel Vargas Ruiz and Juanita Romero-Díaz back in December 2018 while we were at service in Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City.
Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder that predominantly affects women in reproductive years. Immunologic and hormonal adaptations during pregnancy focused on creating an ideal environment to achieve a successful pregnancy represent a challenge in SLE women as they can influence on disease activity and outcomes during pregnancy.
Several disease-related factors such as the presence of antiphospholipid antibodies and anti-SSA/Ro can also impact in the risk of pregnancy adverse outcomes and neonatal complications.
Lupus nephritis and preeclampsia share clinical and laboratory features hindering differentiation between both entities. Contraception constitutes a relevant topic in SLE patients to prevent unplanned pregnancies during periods of disease activity or potentially teratogenic drug exposure, but its potential risk on disease flares and thrombotic events is the main concern. Finally, fertility in patients with SLE can be affected by the use of drugs related to infertility that lead to premature ovarian failure. Recently, assisted reproduction technologies have emerged as a safe option in patients with SLE.
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