Lupus Induced Acute Coronary Syndrome in A Young Nigerian Female: A Case Report

Abstract

Connective tissue diseases are thought to be rare in Nigeria though cases are being reported now. Our experience in Jos points to their not being so rare at least in women. Systemic lupus erythematosus is one of them with multi-system presentation. The case of a young lady with acute coronary syndrome initially missed is hereby reported to show that it is not so rare; and could present with coronary artery disease manifestation. A case of a young lady presenting with features of unstable coronary syndrome but ignored due to absence of traditional risk factors; until she consulted the author is reported. Her history proved suggestive of a connective tissue disease and full evaluation confirmed systemic lupus erythematosus. Her presentation with cardiac symptoms suggestive of coronary artery disease and relative youth led to suspicion of a connective tissue disease. Her electrocardiogram showed transient ischaemia in the inferior leads. Urinalysis showed haematuria and proteinuria suggestive of lupus nephritis; and a rheumatology panel confirmed lupus syndrome. Disease modifying drug treatment got her symptoms resolving. Connective tissue diseases, among which is systemic lupus erythematosus are not as rare in our environment as previously thought. Systemic lupus erythematosus manifests in all symptoms of the body and can present in various ways. Clinicians in our environment should improve their index of suspicion; as prognosis is good if detected early and availed of treatment.

Key Words: Systemic lupus erythematosus, Acute coronary syndrome, Nigeria, Female