Aortic aneurysm and dissection in systemic lupus erythematosus

Spontaneous Coronary Artery Dissection in a Patient with a Family History of Fatal Ascending Aortic Dissection: Case Report and Discussion of Diseases Causing Both Presentations

“…A recent case report attributed SCAD as a first presentation of SLE, however without clinical criteria for SLE and positive ANA and anti-SMA [19]. Systematic review has identified 40 previous cases published of SLE with aortic aneurysm and or dissection [20]. Inflammatory causes are unlikely in our patient as blood tests a few months before her diagnosis were negative for ANA, rheumatoid factor, and ESR.…”

COVID-19 and Acute Aortic Syndromes: Understanding the Dynamic Interplay

“…Vascular damage has been previously identified in other inflammatory diseases such as rheumatoid arthritis, psoriasis, and lupus erythematosus. 4 While we acknowledge that pathological examination of the resected aorta would have better supported our hypothesis, it remains conceivable that the potent inflammatory stimulus of COVID-19 disease, affecting multiple organ systems, might have a role even in the development of acute aortic syndromes. Mori and colleagues, 1 who also reported their surgical experience 5 in a case of intramural hematoma and COVID-19 disease, argued that in our patient this association could be allocated to a simple coincidence.…”

"Pathophysiology of Vascular Manifestations in Systemic Lupus Erythematosus"

“…Apart from the higher incidence and mortality of aneurysm in SLE patient's vs the general population, the age of onset is significantly lower among the former: In two meta-analyses, the median age for onset of AA was around 45 years [72,73], which is around 20 years younger compared to the general population [74]. In addition to that, patients with SLE complicated by abdominal AA are struck with disease around 30 years earlier [56].…”

“…Literature on the mechanism of its development in SLE is rather scarce compared to such of atherosclerosis. Formation of AA is described as an immunerelated process in which cells of the innate and adaptive immune system accumulate in the adventitia of the aortic wall [73]. Apart from this, the pathogeneses of AA and dissection have also been linked to atherosclerosis, aortic elastic tissue degeneration and certain vasculitides [72,73,244,245].…”