SYSTEMIC LUPUS ERYTHEMATOSUS

Handayani Lidiawati*, Aryaningrum Eunike*, Kurniati Nova **

*Resident of Internal Medicine, Medical Faculty of Sriwijaya University/RSMH Palembang

**Division of Allergy-Immunology, Department of Internal Medicine Sriwijaya
University/RSMH Palembang

Introduction. Systemic lupus erythematosus (SLE) is the prototypic multisystem

autoimmune disorder with a broad spectrum of clinical presentations encompassing almost all
organs and tissues. Clinical manifestation of SLE can be lupus nephritis, neuropsychiatric,
mucocutaneous lesion,etc.

Case. A 22 years woman came to the Emergency Room Mohammad Hoesin Hospital, with
chief complaint of a small amount of urine, about 200cc/24hrs, yellowish, joint pain, and
hairfall. On physical examination, we found stomatitis, hairfall, moonface, and pretibial
oedema. On laboratory examination, we found elevated of ureum level on 158 mg/dl,
elevated of creatinine level on 1,35 mg/dL, proteinuria (+). On head CT scan we found
cerebral atrophy (neuropsychiatric lupus). On Chest x-ray we found cardiomegaly. On
echocardiography we found HHD, preserve LVEF.

Discussion. The diagnosis of systemic lupus erithrematous with lupus nephritis and
neuropsychiatric as the clinical manifestation, determined by MEX SLEDAI criteria,
proteinuria on urinalysis, and elevated of ureum and creatinine level. Neuropsychiatry SLE
could be diagnose by the cerebral athropy.

Conclusion.
Lupus nephritis and the involvement of neurologic system in SLE is generally considered as a
serious complication with a poor prognosis.