Aortic aneurysm in systemic lupus erythematosus

Stehbens, William E.; Delahunt, Brett; Shirer, W. C.; Naik, Dilip K.

doi:10.1111/j.1365-2559.1993.tb00119.x

Cited by 18 publications

(7 citation statements)

References 4 publications

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“…Most cases of lupus-associated aortitis have been described in conjunction with aortic aneurysms or aortic dissection. Histologic features have only been reported in a few cases [47,50,54,[75][76][77][78][79]. In lupus aortitis, the inflammatory infiltrate is typically either lymphocytic or lymphoplasmacytic, and not usually granulomatous.…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Stone¹,

Bruneval²,

Angelini³

et al. 2015

Cardiovascular Pathology

278

232

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Inflammatory diseases of the aorta include routine atherosclerosis, aortitis, periaortitis, and atherosclerosis with excessive inflammatory responses, such as inflammatory atherosclerotic aneurysms. The nomenclature and histologic features of these disorders are reviewed and discussed. In addition, diagnostic criteria are provided to distinguish between these disorders in surgical pathology specimens. An initial classification scheme is provided for aortitis and periaortitis based on the pattern of the inflammatory infiltrate: granulomatous/giant cell pattern, lymphoplasmacytic pattern, mixed inflammatory pattern, and the suppurative pattern. These inflammatory patterns are discussed in relation to specific systemic diseases including giant cell arteritis, Takayasu arteritis, granulomatosis with polyangiitis (Wegener's), rheumatoid arthritis, sarcoidosis, ankylosing spondylitis, Cogan syndrome, Behçet's disease, relapsing polychondritis, syphilitic aortitis, and bacterial and fungal infections.

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Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Stone¹,

Bruneval²,

Angelini³

et al. 2015

Cardiovascular Pathology

278

232

View full text Add to dashboard Cite

show abstract

“…gave a pathological description of a non-dissecting AA with SLE. 6 The findings of thrombi with underlying atheromatous debris containing lipophages and medial elastic fibres deep to the debris, did not differ from findings in atherosclerotic AAA without SLE. The absence of necrotic micro-vasculitis accompanied by fibrinoid necrosis otherwise reflected the effect of long-term steroid therapy which resulted in weakening of the medial elastic lamina.…”

Section: Discussionmentioning

confidence: 76%

Endovascular Aneurysm Repair (EVAR) of an Infrarenal Abdominal Aortic Aneurysm (AAA) in a Young Patient with Systemic Lupus Erythematosus (SLE)

Chong

2017

EJVES Short Reports

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IntroductionWhile hypertension, pericardial, myocardial, and coronary artery disease are common cardiovascular manifestations of systemic lupus erythematosus (SLE), aortic aneurysms (AA) are rare but increasingly diagnosed, with the true incidence unknown.Case reportA 40 year old female suffering from SLE with a 5.3 cm saccular eccentric infrarenal abdominal aortic aneurysm (AAA) was treated successfully with endovascular aneurysm repair (EVAR) using the Medtronic Endurant II bifurcated stent graft and followed up 2 years post-operatively. Pre-operatively, open and EVAR options were offered and the latter was chosen by the patient.DiscussionProposed mechanisms for AA formation in SLE including accelerated atherosclerosis brought about by chronic steroid use and SLE associated vasculitis and cystic medial degeneration (CMD) have been discussed in other case reports and series. To the authors' knowledge, the use of EVAR for AAA in SLE patients has not been reported in available literature. The need for earlier repair, screening, and detection as well as the long-term suitability, durability, and surveillance of EVAR remain unknown. The benefit of using the Ovation device in minimising late neck dilatation is also discussed.ConclusionEVAR was demonstrated to be a suitable form of repair in a young female patient with SLE and AAA, followed up 2 years post-surgery. The ideal repair and the natural history of these aneurysms remains to be studied.

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“…The causes of death in many of these cases were attributed to complications from aortic dissection due to active aortitis or to postoperative complications (8,9,15,25). Among the patients who recovered, surgery was performed for aortic dissection or aortic aneurysm, although most reports concerning surgical aortic repair did not mention the induction dose of corticosteroids (7,8,(12)(13)(14)17). Highdose glucocorticoids have been recommended as the initial treatment for Takayasu's arteritis or giant cell arteritis, which are major types of aortitis (34,35).…”

Section: Discussionmentioning

confidence: 99%

Lupus Aortitis Successfully Treated with Moderate-dose Glucocorticoids: A Case Report and Review of the Literature

et al. 2020

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Lupus aortitis is a rare and potentially life-threatening disorder. Previous studies have reported the utility of high-dose systemic glucocorticoids or surgery as the treatment, although there have been no related controlled trials. We herein report a 49-year-old woman with a 35-year history of systemic lupus erythematosus who was diagnosed with aortitis. Her symptoms and laboratory and imaging abnormalities rapidly resolved upon the administration of moderate-dose glucocorticoids. We subsequently performed a literature review of similar cases to identify the appropriate treatment and discuss these cases. A study of further cases will be needed to identify the characteristics of patients who would benefit from moderate-dose glucocorticoid therapy.

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Aortic aneurysm in systemic lupus erythematosus

Cited by 18 publications

References 4 publications

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology: I. Inflammatory diseases

Endovascular Aneurysm Repair (EVAR) of an Infrarenal Abdominal Aortic Aneurysm (AAA) in a Young Patient with Systemic Lupus Erythematosus (SLE)

Lupus Aortitis Successfully Treated with Moderate-dose Glucocorticoids: A Case Report and Review of the Literature

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