Severe preeclampsia in a patient with “Autoimmune Overlap”: a case report

Abstract

Abstract

Introduction

Systemic lupus erythematosus and systemic sclerosis are autoimmune connective tissue diseases characterized by marked clinical heterogeneity and the potential for significant multiorgan involvement. Overlap syndromes represent a complex clinical entity, defined by the coexistence of clinical and immunological criteria of two or more rheumatologic diseases, either simultaneously or sequentially. In the context of pregnancy, these conditions are associated with a substantially increased risk of both maternal and perinatal complications, posing important diagnostic and therapeutic challenges.

Case presentation

A 26-year-old woman with a prior diagnosis of overlap syndrome between systemic lupus erythematosus and systemic sclerosis, who was 28 weeks pregnant. During the course of her pregnancy, she developed severe preeclampsia requiring urgent delivery by cesarean section. Despite the complexity of the clinical scenario, both maternal and neonatal outcomes were favorable.

Conclusions

This case highlights the importance of a multidisciplinary approach in pregnant patients with autoimmune diseases, as well as the need for appropriate preconception counseling and strict disease control. It also underscores the challenges in the differential diagnosis between pregnancy-related complications and manifestations of underlying rheumatologic diseases, particularly in overlap syndromes, where the interaction between both conditions may significantly influence clinical course and prognosis.