The patient with autoimmune disorders

This chapter includes clinical cases, background, evidence-based practical management options, preventive measures and key-point summaries of patient with autoimmune disorders. Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease with a highly variable course of flares and remissions. Treatment, which includes nonsteroidal anti-inflammatory drugs, glucocorticoids and immunosuppressive drugs, aims to minimize or stop disease progression and organ damage. Gonadotoxic effects of cyclophosphamide are permanent and related to cumulative dose, age of exposure and treatment duration. SLE can occur in association with other autoimmune diseases, such as antiphospholipid syndrome. Accurate preconception counseling is required in SLE patients to assess disease activity and drug compatibility with pregnancy. The rate of disease exacerbations after infertility treatments in patients with a well-controlled or quiescent disease appears to be comparable with nonstimulated women with SLE. A strict clinical, serological and laboratory follow-up is mandatory during pregnancy to recognize early the signs of disease flare or pregnancy complications.