Helder Santos, Sara Santos, Kelly Lopes, Catarina Parente, Catarina Carvalho, Inês Almeida, Mariana
Santos, Hugo Miranda, António Cardoso, Joaquim Peixoto, Anabela Santos, Fátima Campante
Systemic lupus erythematosus (SLE) has a variable clinical expression and can be manifested by a single organ or a multiorgan dysfunction. Patients with this condition have higher associated mortality rates, even when the disease seems clinically stable for many years. An event can occur that deregulates the disease at any given time, making it active or uncontrolled again. In uncontrolled patients, the diagnosis is sometimes difficult and both the approach and treatment are crucial for a favorable outcome. This case report describes the challenging management of a young patient who presented neuropsychiatric manifestations, hematological abnormalities and a rapid development of multiorgan dysfunction. During the patient’s hospitalization, three cerebrovascular accidents were registered with a continued worsening of the clinical status, resulting in her death after 33 days. Even with immunosuppression therapy there were several complications, some of which were promptly resolved; however, it was not possible to stop a rapidly progressing autoimmune induced multiorgan failure. The unique features presented by this patient and the rapid progression of the disease are an important alert for all physicians that work in the emergency room.