A Rare Case of a Pregnant Woman with Severe Thrombocytopenia Associated with Systemic Lupus Erythematosus

Abstract This case report describes a 22-year-old pregnant woman with systemic lupus erythematosus (SLE) and severe thrombocytopenia at 32 weeks of gestation with dichorionic diamniotic (DCDA) twins. She had a platelet count of 3,000/μL, persistent thrombocytopenia despite transfusions, and symptoms including rashes and muscle cramps. Diagnosis was confirmed with a positive antinuclear antibody (ANA) test. Treatment included methylprednisolone pulse therapy, hydroxychloroquine, and intravenous immunoglobulin (IVIG). At 34 weeks and 4 days, the patient went into preterm labor and underwent a cesarean section. Preoperative platelet transfusions raised her platelet count to 51,000/μL. Both twins were delivered safely and admitted to the NICU for prematurity. Postoperative care included immunosuppressive therapy, antihypertensives, and antibiotics, with steady improvement in the patient’s condition and platelet count. This case highlights the challenges of managing SLE with severe thrombocytopenia during pregnancy, especially with twins. Early diagnosis, tailored treatment, and coordinated multidisciplinary care led to positive maternal and neonatal outcomes. This emphasizes the importance of proactive management in high-risk pregnancies to ensure the best possible results.