Multiple aortic aneurysms complicated by a rupture in the systemic lupus erythematosus: A case report

被引:14
作者
Sato, Junichiro [2 ]
Kawakami, Tomohiro [2 ]
Nakabayashi, Kimimasa [3 ]
Fukuoka, Kazuhito [3 ]
Hirano, Kazuhiko [1 ]
Terado, Yuichi [1 ]
Yokoyama, Kenichi [4 ]
Ohtsuka, Takako [3 ]
Ohkura, Yasuo [1 ]
Fujioka, Yasunori [1 ]
Kurata, Atsushi [1 ]
机构
[1] Kyorin Univ, Sch Med, Dept Pathol, Mitaka, Tokyo 1818611, Japan
[2] Kyorin Univ, Sch Med, Tokyo, Japan
[3] Kyorin Univ, Sch Med, Dept Internal Med, Tokyo, Japan
[4] Kyorin Univ, Sch Med, Dept Radiol, Tokyo, Japan
关键词
Antiphospholipid antibody syndrome; Cystic medial necrosis; Multiple aneurysms; Rupture; Systemic lupus erythematosus;
D O I
10.1016/j.prp.2008.05.009
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
We report the case of a 61-year-old female who suffered from systemic lupus erythematosus (SLE) and died of a ruptured abdominal aortic aneurysm (AA). She was diagnosed to have SLE at 39 years of age, and was administrated steroids and prostaglandin E-2. From 52 years of age, AA, peripheral arterial occlusion, and multiple organ infarctions appeared repeatedly. At 59 years of age, she was found to be affected by antiphospholipid antibody syndrome (APS). In the following year, expansion of an abdominal AA was identified, but she was given only conservative treatment. In the next year, sudden epigastralgia and dyspnea occurred, and she died. An autopsy revealed multiple AAs up to 11 cm in diameter, one of which showed ruptures, forming a retroperitoneal hematoma. Marked atherosclerosis of the aorta was noted, and she also had aortic dissection accompanied by cystic medial necrosis (CMN). An old myocardial infarction and brain infarction were also confirmed. Although SLE with APS is common, a complication of the disease by CMN, multiple AAs, or ruptured AA has been described in several cases to date. Regarding the etiology of this complicated presentation, we presume synergistic involvement of various factors, such as atherosclerosis and CMN associated with SLE, thrombosis due to APS, and prolonged steroid therapy. (C) 2008 Elsevier GmbH. All rights reserved.
引用
收藏
页码:845 / 850
页数:6
相关论文
共 27 条
[1]   Acute type A aortic dissection in a patient with systemic lupus erythematosus [J].
Aoyagi, S ;
Akashi, H ;
Otsuka, H ;
Sakashita, H ;
Okazaki, T ;
Tayama, K .
JAPANESE HEART JOURNAL, 2002, 43 (05) :567-571
[2]   FIBRILLIN ABNORMALITIES AND PROGNOSIS IN MARFAN-SYNDROME AND RELATED DISORDERS [J].
AOYAMA, T ;
FRANCKE, U ;
GASNER, C ;
FURTHMAYR, H .
AMERICAN JOURNAL OF MEDICAL GENETICS, 1995, 58 (02) :169-176
[3]   Premature coronary-artery atherosclerosis in systemic lupus erythematosus [J].
Asanuma, Y ;
Oeser, A ;
Shintani, AK ;
Turner, E ;
Olsen, N ;
Fazio, S ;
Linton, MF ;
Raggi, P ;
Stein, CM .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (25) :2407-2415
[4]   Pathology and pathogenesis of vascular injury in systemic lupus erythematosus - Interactions of inflammatory cells and activated endothelium [J].
Belmont, HM ;
Abramson, SB ;
Lie, JT .
ARTHRITIS AND RHEUMATISM, 1996, 39 (01) :9-22
[5]   THROMBOSIS IN SYSTEMIC LUPUS-ERYTHEMATOSUS - STRIKING ASSOCIATION WITH THE PRESENCE OF CIRCULATING LUPUS ANTICOAGULANT [J].
BOEY, ML ;
COLACO, CB ;
GHARAVI, AE ;
ELKON, KB ;
LOIZOU, S ;
HUGHES, GRV .
BMJ-BRITISH MEDICAL JOURNAL, 1983, 287 (6398) :1021-1023
[6]   CYSTIC MEDIAL NECROSIS OF ASCENDING AORTA IN RELATION TO AGE AND HYPERTENSION [J].
CARLSON, RG ;
LILLEHEI, WC ;
EDWARDS, JE .
AMERICAN JOURNAL OF CARDIOLOGY, 1970, 25 (04) :411-&
[7]  
Chang Wen-Liang, 2004, Journal of Microbiology Immunology and Infection, V37, P310
[8]   Systemic lupus erythematosus [J].
D'Cruz, David P. ;
Khamashta, Munther A. ;
Hughes, Graham R. V. .
LANCET, 2007, 369 (9561) :587-596
[9]  
GLADMAN DD, 2004, SYSTEMIC LUPUS ERYTH, P697
[10]   TGF-beta latency: Biological significance and mechanisms of activation [J].
Gleizes, PE ;
Munger, JS ;
Nunes, I ;
Harpel, JG ;
Mazzieri, R ;
Noguera, I ;
Rifkin, DB .
STEM CELLS, 1997, 15 (03) :190-197