Major Depressive Disorder in a Patient with Systemic Lupus Erythematous, Pulmonary Hypertension, and Hypercoagulation: A Case Report

Muhammad Yamin, Edward Faisal, Rudi Putranto, Hamzah Shatri


Major depressive disorder is characterized by the presence of single or repeated major depressive episodes, which are considered periods of 2 weeks of depressive moods featuring impaired neurovegetative functioning, psychomotor activity, and cognition, as well as suicidal thoughts. Major depressive disorder is commonly associated with other medical conditions, especially chronic and systemic medical illnesses. Cardiovascular diseases are among the most related, especially pulmonary hypertension, a cardiovascular disorder that results in increased pulmonary circulation pressure––with an average resting pulmonary artery pressure of at least 25 mmHg––and which the WHO has associated with several other conditions, including connective tissue diseases such as scleroderma and systemic lupus erythematosus (SLE). The patient in this case is a 39-year-old woman diagnosed with major depressive disorder and SLE-associated pulmonary artery hypertension, which has been associated with hypercoagulable states, as observed in this instance. The complicated associations between these problems require collaboration between disciplines to establish optimal treatment integrity, with palliative care necessary to improve this patient’s quality of life.


Depressive disorder; Pulmonary Hypertension (PH); Systemic Lupus Erythematous (SLE); Hypercoagulation


Thom R, Silbersweig DA, Boland R. Major depressive disorder in medical illness: A review of assessment, prevalence, and treatment options. American Psychosomatic Society. 2019.

Grobler G. Major depressive disorder. South African Journal of Psychiatry. 2013.

Bains N, Abdijadid N. Major depressive disorder. StatPearls. 2020.

Kenneth M, Gregory L. Psychological factors in heart failure: A review of literature. Arch Intern Med. 2002.

Bordoni, Bruno. Depression and anxiety in patients with chronic heart failure. Future Cardiol. 2018.

Tonelli AR, Arelli V, Minai OA, et al. Causes and circumstances of death in pulmonary arterial hypertension. Am J Respir Crit Care Med. 2013.

Dhala, Atiya. Pulmonary arterial hypertension in systemic lupus erithematosus: Current status and future direction. Clinical and Developmental Immunology. 2012.

Brown LM, Chen H, Halpern S, et al. Delay in recognition of pulmonary arterial hypertension: factors identified from the REVEAL Registry. Chest. 2011.

Frost AE, Badesch DB, Barst RJ, et al. The changing picture of patients with pulmonary arterial hypertension in the United States: how REVEAL differs from historic and non-US Contemporary Registries. Chest. 2011.

Gomez S, Hansmannb G, Walter Kl, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension – web addenda. European Heart Journal. 2015.

Antonis F, Kostopoulou K, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. 2019.

Patel Raj, Gregory R. Persistent depressive disorder (dysthymia). StatPearls. 2020.

Uher R, Payne JL, Pavlova B, Perlis RH. Major depressive disorder in DSM-5: implications for clinical practice and research of changes from DSM-IV. Depress Anxiety. 2014.

Vandeleur CL, Fassassi S, Castelao E, et al. Prevalence and correlates of DSM-5 6. Medical therapy for heart failure associated with pulmonary hypertension. Circulation. 2019.

Isabel B, Wassim F. Hypercoagulability in pulmonary hypertension. Clin Chest Med. 2018.

Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013.

Aringer M, Leuchten N, Johnson SR. New criteria for lupus. Current Rheumatology Reports. 2020.

Aringer M, Karen C, David D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. American College of Rheumatology. 2019.

Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry. 2011.

Heo, Seongkum, et al. Quality of life in patients with heart failure: Ask the patients. NIH Public Access. 2009.

Kavalierato. Palliative care in heart failure: Rationale, evidence, and future priorities. J Am Coll Cardiol. 2017.

Full Text: PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.