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Systemic lupus erythematosus (SLE) is an auto-immune systemic disease showing a strong predilection for women of reproductive age. Higher prevalance of SLE among young women are in part accounted for by the effects of estrogen hormone on immune system. The key pathophysiological features of this disease are the generation of autoantibodies and the deposition of antibody-antigen complexes in the basal membranes of the organs where they evoke inflammatory responses and injury. Young females diagnosed with SLE are more prone to developing a multitude of adverse reproductive and obstetric outcomes, especially in the presence of active disease. Our motivation in writing this review article is to outline the recent interesting findings of molecular and clinical studies showing multi-faceted roles of estrogen hormone in both normal immune function and auto-immunity and to provide an update on the ovarian function and other poor reproductive outcomes in young females with SLE.

A 24-year-old primigravid woman at 28 weeks of gestation was admitted to the hospital because of drug-refractory atrial tachycardia and heart failure. The arrhythmia did not respond to drug therapy and electrical cardioversion. Since tachycardia was intractable and had potentially life-threatening consequences for mother and foetus, it was decided to ablate the tachycardia after a multidisciplinary meeting. During the procedure, maternal hypotension occurred, consequently causing persistent foetal heart rate reduction. Radiofrequency ablation was immediately cancelled and emergency caesarean section was carried out. After 72 hours after the caesarean-section, successful RF ablation could be performed. Mother was discharged on the seventh postoperative day. The newborn was hospitalised until having reached 2500 g and he was discharged in good condition. Mother’s left ventricle systolic function significantly improved and no atrial tachyarrhythmia was observed on the sixth month follow-up visit.