Histopathological analysis of cerebral hemorrhage in systemic lupus erythematosus complicated with antiphospholipid syndrome

Abstract

A 53-year-old woman was admitted due to akinetic mutism and fever. On admission, brain computed tomography (CT) scan revealed a large hemorrhagic lesion in the left anterior lobe that required surgical operation for total removal. Her neuropsychiatric manifestation was not attenuated after the operation, and was gradually ameliorated by high doses of corticosteroid thereafter, suggesting a diagnosis of lupus psychosis. Histopathological examination revealed a necrotizing vasculature, sometimes with a disrupted lamina elastica interna, completely filled with thrombi and infiltrated with inflammatory cells and their debris. It is therefore suggested that the large frontal lobe hematoma in our patient was induced by thrombosis and arteritis in the subarachnoid space.

Massive haemorrhage: an unusual presentation of systemic lupus erythematosus

“…Arinuma et al described necrotising vasculitis in antiphospholipid antibodies profile-related systemic lupus erythematosus. 7 In our case antiphospholipid antibodies profile was negative.…”

“…6 Intracerebral bleed (ICB) in the systemic lupus erythematosus secondary to vasculitis is rarely reported in the literature. [7][8] Massive haematuria in systemic lupus erythematosus hasn't been documented in literature before in this regard. Moreover mucosal and subcutaneous bleeding are also rare to find in the literature.…”