A CASE REPORT ON SYSTEMIC LUPUS ERYTHEMATOUS WITH AUTOIMMUNE HAEMOLYTIC ANEMIA

Abstract

Systemic Lupus Erythematous (SLE) is a chronic autoimmune disease where the immune system attacks its own tissues, causing inflammation and tissue damage in affected organs like the skin, joints, kidneys, and brain. It is characterized by the presence of antinuclear antibodies (ANA) and multi-organ system involvement. The cause is unknown but may be linked to genetic, environmental, hormonal, and certain medications. Women of childbearing age 15 to 44 years are at the greatest risk of developing SLE. In mild cases, hydroxychloroquine and non-steroidal anti-inflammatory drugs are used, while corticosteroids and immunosuppressive therapies are reserved for major organ involvement. In more severe cases, treated with anti-CD20 monoclonal antibody. Autoimmune Haemolytic Anemia (AIHA) is a condition where the body produces antibodies against antigens causing haemolysis in red blood cells, leading to a low number of red blood cells.In this report, A 36-year-old female patient presented with fever, vomiting, anorexia, dizziness, asthenia, and severe myalgia. She had a history of jaundice, Dengue, Auto Immune Haemolytic Anemia, and a surgical history of LSCS. Her laboratory tests reveals elevated WBC, MCV, MCH, RDW, monocytes, and decreased Hb, PCV, MCHC, lymphocytes, and eosinophils. Her liver function tests showed increased bilirubin, decreasedtotal protein. The count in Biochemistry C4 and C3 decreased whereas Lactate dehydrogenase (LDH), vitamin B-12 are elevated. Positive findings from both Direct coombs Test (DCT) and Indirect Coombs Test (IDCT). Immunological screening results were positive for anti-nuclear antibody(ANA). The patient’s oral medication includes methyprednisone , ursodeoxycholic acid , Becovit Forte, hydroxychloroquine sulphate.