Systemic Lupus Erythematosus Coronary Vasculitis Demonstrated on Cardiac Computed Tomography

Shriki, Jabi E.; Shinbane, Jerold S.; Azadi, Nazanin; Su, Tien I Karleen; Hirschbein, Jonah; Quismorio, Francisco P.; Bhargava, Puneet

doi:10.1067/j.cpradiol.2014.05.005

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…Coronary arteritis in SLE appears similar in both children and adults and is characterized by aneurysmal dilatation, both focal and diffuse, with or without areas of stenosis (33-35) ( Fig 5). These findings have been more commonly demonstrated at echocardiography (34) and conventional angiography (35), although similar findings are visible at CT (36). Following treatment, the coronary arterial lesions may improve or resolve completely (34).…”

Section: Immune System-mediated Conditionsmentioning

confidence: 61%

Abnormalities of the Coronary Arteries in Children: Looking beyond the Origins

et al. 2017

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Coronary arterial abnormalities are uncommon findings in children that have profound clinical implications. Although anomalies of the coronary origins are well described, there are many other disease processes that affect the coronary arteries. Immune system-mediated diseases (eg, Kawasaki disease, polyarteritis nodosa, and other vasculiditides) can result in coronary arterial aneurysms, strictures, and abnormal tapering of the vessels. Because findings at imaging are an important component of diagnosis in these diseases, the radiologist's understanding of them is essential. Congenital anomalies may present at varying ages, and findings in hemodynamically significant anomalies, such as fistulas, are key for both diagnosis and preoperative planning. Pediatric heart surgery can result in wide-ranging postoperative imaging appearances of the coronary arteries and also predisposes patients to a multitude of complications affecting the heart and coronary arteries. In addition, although rare, accidental trauma can lead to injury of the coronary arteries, and awareness and detection of these conditions are important for diagnosis in the acute setting. Patients with coronary arterial conditions at presentation may range from being asymptomatic to having findings of myocardial infarction. Recognition of the imaging findings is essential to direct appropriate treatment. RSNA, 2017.

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Section: Immune System-mediated Conditionsmentioning

confidence: 61%

Abnormalities of the Coronary Arteries in Children: Looking beyond the Origins

et al. 2017

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“…There is no established therapy for SLE coronary vasculitis, although few case reports have reported clinical benefits with intravenous pulse dose methylprednisolone associated with intravenous cyclophosphamide in active SLE patients [ 83 , 125 , 141 ]. When SLE coronary vasculitis is refractory to immunosuppressant therapy, an orthotropic heart transplant should be performed [ 126 ].…”

Section: Treatmentmentioning

confidence: 99%

Lupus Vasculitis: An Overview

et al. 2021

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Lupus vasculitis (LV) is one of the secondary vasculitides occurring in the setting of systemic lupus erythematosus (SLE) in approximately 50% of patients. It is most commonly associated with small vessels, but medium-sized vessels can also be affected, whereas large vessel involvement is very rare. LV may involve different organ systems and present in a wide variety of clinical manifestations according to the size and site of the vessels involved. LV usually portends a poor prognosis, and a prompt diagnosis is fundamental for a good outcome. The spectrum of involvement ranges from a relatively mild disease affecting small vessels or a single organ to a multiorgan system disease with life-threatening manifestations, such as mesenteric vasculitis, pulmonary hemorrhage, or mononeuritis multiplex. Treatment depends upon the organs involved and the severity of the vasculitis process. In this review, we provide an overview of the different forms of LV, describing their clinical impact and focusing on the available treatment strategies.

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“…There have been some documented cases of coronary artery vasculitis in adult SLE [8][9][10]. In adults, coronary involvement appears to occur well into the disease course, and when SLE is active.…”

Section: Discussionmentioning

confidence: 95%

“…While coronary vessel involvement is commonly seen in patients with other systemic rheumatologic conditions, such as Takayasu arteritis, ANCA associated vasculitis, microscopic polyangiitis, and Churg-Strauss syndrome [6,7], only a few case reports have previously documented coronary arteritis in adult-onset SLE as an unusual finding [8][9][10]. When coronary arteritis is identified in adult-onset SLE, it is seen with vasculitis in other organ systems as well [5].…”

Section: Introductionmentioning

confidence: 99%