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Mohanasundaram S, Samuel MK, Kurien AA. Abdominal Pain in a Female with Lupus - Opening the Pandora's Box. Indian J Nephrol 2024; 34:181-184. [PMID: 38681004 PMCID: PMC11044692 DOI: 10.4103/ijn.ijn_316_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/08/2022] [Indexed: 05/01/2024] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve multiple organ systems. The most common form of vasculitis seen in SLE is small vessel vasculitis. Aortitis in SLE or antiphospholipid syndrome is an extremely rare complication. Here, we present a 32-year-old female who presented with a history of prolonged abdominal pain, who was evaluated and diagnosed to have aortitis as an unusual involvement in SLE with secondary antiphospholipid antibody syndrome.
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Affiliation(s)
- Subashri Mohanasundaram
- Assistant Professor, Department of Nephrology, Government Thoothukudi Medical College and Hospital, Thoothukudi, Tamil Nadu, India
| | - Marchwin Kingston Samuel
- Head of the Department- in-Charge, Associate Professor of General Medicine, Department of Nephrology, Government Thoothukudi Medical College and Hospital, Thoothukudi, Tamil Nadu, India
| | - Anila A. Kurien
- Renopath Center for Renal and Urological Pathology Pvt Ltd., Chennai, Tamil Nadu, India
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2
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Escoda T, George J, Jarrot PA, Jean R, Mazodier K, Sanderson F, Poullin P, Saby L, Jourde-Chiche N, Kaplanski G, Chiche L. Aortitis is an under-recognized manifestation of antiphospholipid syndrome: A case report and literature review. Lupus 2022; 31:744-753. [PMID: 35341372 DOI: 10.1177/09612033221091142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aortitis is a classic manifestation of large vessel vasculitis. Antiphospholipid syndrome (APS), sometimes known as Hughes syndrome, is an acquired autoimmune disorder that manifests clinically as recurrent venous or arterial thrombosis. Patients with APS may also suffer from various underlying diseases, most frequently systemic lupus erythematosus (SLE). Catastrophic antiphospholipid syndrome (CAPS) is a rare but serious complication of APS characterized by failure of several organs due to diffuse microcirculatory thrombi. Its main manifestations involve the kidneys, lungs, heart and central nervous system, and require early diagnosis and rapid therapeutic management. While APS can affect virtually any blood vessel, aortitis is not a known symptom of APS. We report the case of a 36-year-old patient with APS and SLE who presented with CAPS during pregnancy, with no concomitant SLE flare. The first manifestation of CAPS was aortitis, preceding renal, cardiac and haematological manifestations. The outcome was favourable with combined treatment including corticosteroids, anticoagulants, plasma exchange and rituximab. We then carried out a literature search for papers describing the presence of aortitis in APS and/or SLE. In the cases of aortic involvement identified in the literature, including another case of CAPS, the occurrence of aortitis in SLE, often associated with the presence of antiphospholipid antibodies/APS, suggests that aortitis should be considered as an under-recognized manifestation and potential non-criterion feature of APS.
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Affiliation(s)
- Thomas Escoda
- Service de Médecine Interne, 36900CHU Conception, Marseille, France.,Service de Médecine Interne, 36900Hôpital Européen, Marseille, France
| | - Julia George
- Service de Médecine Interne, 36900CHU Conception, Marseille, France
| | | | - Rodolphe Jean
- Service de Médecine Interne, 36900CHU Conception, Marseille, France
| | - Karin Mazodier
- Service de Médecine Interne, 36900CHU Conception, Marseille, France
| | | | - Pascale Poullin
- Service d'Hémaphérèse, 36900CHU Conception, Marseille France
| | - Ludivine Saby
- Service de Cardiologie, 36900Hôpital Européen, Marseille, France
| | | | - Gilles Kaplanski
- Service de Médecine Interne, 36900CHU Conception, Marseille, France
| | - Laurent Chiche
- Service de Médecine Interne, 36900Hôpital Européen, Marseille, France
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3
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Jesrani G, Gupta S, Gupta S, Raju T, Gupta M. Systemic lupus erythematosus presenting as unprovoked brachio-cephalic vein thrombosis: A case report. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2022. [DOI: 10.4103/jdrntruhs.jdrntruhs_129_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Santacruz JC, Londoño JD, Panqueva U, Cuervo F. Aortitis: An Unusual Inflammatory Complication of Systemic Lupus Erythematosus. Cureus 2021; 13:e18028. [PMID: 34671519 PMCID: PMC8520493 DOI: 10.7759/cureus.18028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 11/30/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can involve any organ system. Vasculitides are classified according to the predominant vessel involved such as large vessel, medium vessel, or small vessel vasculitis. Of these, Takayasu arteritis, Behcet's disease, relapsing polychondritis, and immunoglobulin G4 (IgG4)-related disease predominantly involve large vessels. The most common form of vasculitis seen in SLE is small vessel vasculitis. Aortitis in SLE is an extremely rare complication. This is a case report of a 21-year-old female patient with a history of SLE with overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis associated with antiphospholipid syndrome (APS), who presented with a one-week history of left-back burning lumbar pain, radiating to the flank, which increased with changes in position associated with intermittent claudication. In the angiography images and the positron emission tomography (PET) scan, a hypometabolic left para-aortic oval image was noted, corresponding to the presence of a contained hematoma in an abdominal aorta rupture. Later, she underwent vascular surgery and hemodynamics, performing thoracoabdominal aortic reconstruction together with aortorenal bypass and left nephrectomy. Pathology fundings of the left kidney correspond with class IV lupus nephritis, and the resection sample of the thoracoabdominal aneurysm showed a marked thinning and fragmentation of elastic fibers, areas of fibrosis of the wall with severe IgG4 negative lymphoplasmacytic infiltrate in the immunohistochemical study, establishing the diagnosis of aortitis.
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Affiliation(s)
| | - John Dario Londoño
- Spondyloarthropathies Research Group, Universidad de la Sabana, Chía, COL
| | - Uriel Panqueva
- Rheumatology Department, Fundación Cardioinfantil, Bogotá, COL
| | - Francy Cuervo
- Spondyloarthropathies Research Group, Universidad de la Sabana, Chía, COL
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5
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Akebo H, Sada R, Matsushita S, Ishimaru H, Minoda S, Miyake H, Tsugihashi Y, Hatta K. Lupus Aortitis Successfully Treated with Moderate-dose Glucocorticoids: A Case Report and Review of the Literature. Intern Med 2020; 59:2789-2795. [PMID: 32641654 PMCID: PMC7691017 DOI: 10.2169/internalmedicine.4964-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
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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Affiliation(s)
- Hiroyuki Akebo
- Department of General Internal Medicine, Tenri Hospital, Japan
| | - Ryuichi Sada
- Department of General Internal Medicine, Tenri Hospital, Japan
| | - Sho Matsushita
- Department of General Internal Medicine, Tenri Hospital, Japan
| | | | - Saki Minoda
- Department of General Internal Medicine, Tenri Hospital, Japan
| | - Hirofumi Miyake
- Department of General Internal Medicine, Tenri Hospital, Japan
| | | | - Kazuhiro Hatta
- Department of General Internal Medicine, Tenri Hospital, Japan
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6
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Akiyama M, Kaneko Y, Takeuchi T. Lupus aortitis: A fatal, inflammatory cardiovascular complication in systemic lupus erythematosus. Lupus 2020; 29:1652-1654. [PMID: 32791931 DOI: 10.1177/0961203320950017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mitsuhiro Akiyama
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Abstract
Diagnosis of the inflammatory aortopathies and importantly, their distinction in the later stages of disease from genetically mediated or acquired (degenerative) aortopathy remains a challenging clinical problem. Historically, the diagnosis of inflammatory aortopathy has required tissue sampling and pathological assessment. Although histological diagnosis remains an important diagnostic criterion, the ability to obtain sufficient tissue samples is problematic and requires invasive approaches that pose important risk. Continuing refinement in the capabilities of multimodality imaging, including ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography provides important insights into the broad spectrum of disease which comprise the inflammatory aortopathies. This review examines the current and emerging role of multimodality imaging in the evaluation of aortitis.
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Affiliation(s)
- John P Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Roldan PC, Greene ER, Qualls CR, Sibbitt WL, Roldan CA. Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus. Rheumatol Int 2019; 39:1027-1036. [PMID: 30877372 DOI: 10.1007/s00296-019-04267-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 02/26/2019] [Indexed: 12/31/2022]
Abstract
The progression of atherosclerosis versus arterial stiffness with age within and between arteries has not been defined. Systemic lupus erythematosus (SLE) is a human model of accelerated arterial disease that may permit this determination. 76 SLE patients (69 women, age 37 ± 12 years) and 26 age-and-sex-matched controls (22 women, age 34 ± 11 years) underwent transesophageal echocardiography and carotid ultrasonography for assessment of atherosclerosis [plaques and intima-media thickening (IMT)] and arterial stiffness [increased pressure-strain elastic modulus (PSEM)] of the descending thoracic aorta and carotid arteries. Since IMT is highly associated with plaques, IMT was used as a marker of atherosclerosis to assess its progression in relation with age and PSEM. Aortic and carotid plaques, IMT, and PSEM were greater in patients than in controls (all p ≤ 0.05). Within the aorta and within the carotid arteries, the average percent increases per decade of age for IMT versus PSEM were similar in patients (8.55% versus 9.33% and 3.39% versus 2.46%, respectively) and controls (5.53% versus 6.60% and 4.75% versus 3.49%, respectively) (all p ≥ 0.58). However, in SLE patients, the average percent increases per decade of age for IMT and PSEM were higher in the aorta than in the carotid arteries (8.55% and 9.33% versus 3.39% and 2.46%, respectively, both p ≤ 0.03). In patients with SLE, atherosclerosis and arterial stiffness progress with age parallel to each other within arteries, but divergently between arteries with different anatomy and hemodynamics.
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Affiliation(s)
- Paola C Roldan
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Ernest R Greene
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Clifford R Qualls
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Wilmer L Sibbitt
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Carlos A Roldan
- Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA.
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9
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Skeik N, Ostertag-Hill CA, Garberich RF, Alden PB, Alexander JQ, Cragg AH, Manunga JM, Stephenson EJ, Titus JM, Sullivan TM. Diagnosis, Management, and Outcome of Aortitis at a Single Center. Vasc Endovascular Surg 2017; 51:470-479. [PMID: 28859604 DOI: 10.1177/1538574417704296] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Aortitis is a rare condition with inflammatory or infectious etiology that can be difficult to diagnose due to the highly variable clinical presentation and nonspecific symptoms. However, current literature on the diagnosis, management, and prognosis of aortitis is extremely scarce. METHODS We retrospectively reviewed all patients' charts who were diagnosed with giant cell arteritis, Takayasu arteritis, or noninfectious aortitis presenting at a single center between January 1, 2009, and April 17, 2015. Data collected included demographics, medical history, comorbidities, laboratory and imaging data, management, and outcome. RESULTS Among the included 15 patients presenting with aortitis at our center, 53% were diagnosed with Takayasu arteritis, 33% with idiopathic inflammatory aortitis, and 13% with giant cell arteritis. All patients received steroid treatment, 67% received adjunctive immunosuppressants or immunomodulators, and 33% underwent interventional procedures. Based on clinical presentation and laboratory and imaging findings at the last follow-up visit for each patient, 67% showed improvement, 27% had no change in disease activity, and 7% had a progression of the disease. CONCLUSIONS Takayasu arteritis was found to be more common than idiopathic inflammatory aortitis and giant cell arteritis among our 15 cases diagnosed with aortitis. All patients received medical therapy and 33% received interventional procedures, leading to 67% improvement of disease activity or related complications. This article also offers a comprehensive review of the diagnosis, management, and outcome of aortitis, supplementing the very limited literature on this disease.
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Affiliation(s)
- Nedaa Skeik
- 1 Vascular Medicine, Minneapolis Heart Institute, Minneapolis, MN, USA
| | | | - Ross F Garberich
- 2 Minneapolis Heart Institute Research Foundation, Minneapolis, MN, USA
| | - Peter B Alden
- 3 Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Jason Q Alexander
- 3 Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Andrew H Cragg
- 3 Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Jesse M Manunga
- 3 Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN, USA
| | | | - Jessica M Titus
- 3 Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN, USA
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Pérez Ruiz J, Salman-Monte TC, Pros-Simón A, Mestre-Fusco A, Carbonell i Abellò J. Vasculitis aórtica en un paciente con lupus eritematoso sistémico. ACTA ACUST UNITED AC 2016; 12:169-72. [DOI: 10.1016/j.reuma.2015.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/18/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022]
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11
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Jung SY, Park HS, Jhee JH, Lee CK, Lee JY, Park JE, Han SH, Park YB, Lee SK, Lee SW. A Case of Aortitis with Systemic Lupus Erythematosus. JOURNAL OF RHEUMATIC DISEASES 2015. [DOI: 10.4078/jrd.2015.22.3.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Su-Young Jung
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Sun Park
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hyun Jhee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Choong-Kun Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Yeon Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Eun Park
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Hee Han
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Beom Park
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Kon Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Won Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Sokalski DG, Copsey Spring TR, Roberts WN. Large artery inflammation in systemic lupus erythematosus. Lupus 2013; 22:953-6. [PMID: 23761181 DOI: 10.1177/0961203313492241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 23-year-old African-American woman with a history of recurrent pneumonias presented to the hospital with 2 weeks of shortness of breath, chest pain, fevers, and lightheadedness. The histologic diagnosis proved to be lupus aortitis. Optimal Framingham risk factor management by itself may not be a completely successful approach in diminishing the extra risk of atherosclerosis conferred by systemic lupus erythematosus (SLE). Therefore it remains possible that important modifiable cardiovascular risk factors may include low-grade SLE disease activity in medium-sized vessels. The implication of the idea that subclinical vessel inflammation is widespread in patients with lupus-and that this inflammation confers a significant part of the patients' risk of accelerated atherosclerosis-might be a lowering of the threshold for aggressive disease-modifying treatment of lupus, essentially a "treat-to-target" approach to systemic lupus.
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Affiliation(s)
- D G Sokalski
- Division of Rheumatology, Allergy and Immunology, Virginia Commonwealth University, Richmond, TN, USA
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Fayad ZY, Semaan E, Fahoum B, Briggs M, Tortolani A, D’Ayala M. Aortic Mural Thrombus in the Normal or Minimally Atherosclerotic Aorta. Ann Vasc Surg 2013; 27:282-90. [DOI: 10.1016/j.avsg.2012.03.011] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 03/09/2012] [Accepted: 03/17/2012] [Indexed: 10/27/2022]
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14
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Roldan PC, Ratliff M, Snider R, Macias L, Rodriguez R, Sibbitt W, Roldan CA. Aortic Atherosclerosis in Systemic Lupus Erythematosus. ACTA ACUST UNITED AC 2013; Suppl 5. [PMID: 25593786 PMCID: PMC4292892 DOI: 10.4172/2161-1149.s5-006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aortic atherosclerosis (AoA) defined as intima-media thickening or plaques and aortic stiffness (AoS) also considered an atherosclerotic process and defined as decreased vessel distensibility (higher pulse pressure to achieve similar degree of vessel distension) are common in patients with SLE. Immune-mediated inflammation, thrombogenesis, traditional atherogenic factors, and therapy-related metabolic abnormalities are the main pathogenic factors of AoA and AoS. Pathology of AoA and AoS suggests an initial subclinical endothelialitis or vasculitis, which is exacerbated by thrombogenesis and atherogenic factors and ultimately resulting in AoA and AoS. Computed tomography (CT) for detection of arterial wall calcifications and arterial tonometry for detection of increased arterial pulse wave velocity are the most common diagnostic methods for detecting AoA and AoS, respectively. MRI may become a more applicable and accurate technique than CT. Although transesophageal echocardiography accurately detects earlier and advanced stages of AoA and AoS, it is semi-invasive and cannot be used as a screening method. Although imaging techniques demonstrate highly variable prevalence rates, on average about one third of adult SLE patients may have AoA or AoS. Age at SLE diagnosis; SLE duration; activity and damage; corticosteroid therapy; metabolic syndrome; chronic kidney disease; and mitral annular calcification are common independent predictors of AoA and AoS. Also, AoA and AoS are highly associated with carotid and coronary atherosclerosis. Earlier stages of AoA and AoS are usually subclinical. However, earlier stages of disease may be causally related or contribute to peripheral or cerebral embolism, pre-hypertension and hypertension, and increased left ventricular afterload resulting in left ventricular hypertrophy and diastolic dysfunction. Later stages of disease predisposes to visceral ischemia, aortic aneurysms and aortic dissection. Even earlier stages of AoA and AoS have been associated with increased cardiovascular and cerebrovascular morbidity and mortality of SLE patients. Aggressive non-steroidal immunosuppressive therapy and non-pharmacologic and pharmacologic interventions for control of atherogenic risk factors may prevent the development or progression of AoA and AoS and may decrease cardiovascular and cerebrovascular morbidity and mortality in SLE.
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Affiliation(s)
- Paola C Roldan
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Michelle Ratliff
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Richard Snider
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Leonardo Macias
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Rodrigo Rodriguez
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Wilmer Sibbitt
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
| | - Carlos A Roldan
- Department of Internal Medicine and Cardiology Division, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, New Mexico, USA
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Chakrabarti N, Chattopadhyay C. Aortoarteritis with systemic lupus erythematosus and secondary antiphopholipid syndrome. Indian Dermatol Online J 2012; 3:66-8. [PMID: 23130270 PMCID: PMC3481929 DOI: 10.4103/2229-5178.93483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nandini Chakrabarti
- Department of Gen Medicine, NRS Medical College and Hospital, Kolkata, India
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16
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Successful treatment of a thrombus in the left aortic coronary sinus in a child with systemic lupus erythematosus. Cardiol Young 2010; 20:100-2. [PMID: 19849879 DOI: 10.1017/s1047951109991880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report our experience in a 12 year old boy referred with suspected myocardial infarction. He has previously been diagnosed with systemic lupus erythematosus, and was being treated with steroids. Echocardiographic examination revealed a thrombus in the left aortic coronary sinus of Valsalva partially occluding the orifice of the left coronary artery. The thrombosis was successfully treated by venous thrombolysis using recombinant tissue plasminogen activator.
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Affiliation(s)
- Heather L Gornik
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Breynaert C, Cornelis T, Stroobants S, Bogaert J, Vanhoof J, Blockmans D. Letter To the Editor. Lupus 2008; 17:72-4. [DOI: 10.1177/0961203307084172] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - J. Bogaert
- Radiology Department, University Hospital Gasthuisberg, Leuven, Belgium
| | - J. Vanhoof
- Rheumatology Department, Biomedical Research Institute, University Hasselt, Belgium
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