Ref. # 37658
A 25 year old Missouri woman developed a rash of unknown origin in the fifth or sixth month of pregnancy. The rash continued postpartum, with C/O arthralgias. Two weeks postpartum the patient was diagnosed with SLE; she expired from Lupus complications thereafter. A medQuest rheumatologist reported that two dermatologists and a consulted rheumatologist failed to diagnose Lupus despite sufficient information. The treating rheumatologist started the patient on a low dose of steroids without a documented explanation. Although the results of initial tests were positive for ANA and cardiolipins, and indicated low compliments--which do not decline during a normal pregnancy--the treating rheumatologist did not order further tests. The patient died from a stroke, which may have been prevented through prompt treatment with a high dose of steroids.