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[Aortic dissection and annulo-aortic ectasia complicating systemic lupus erythematousus; report of a case]

S Okada1, T Kaneko, M Ezure

  • 1Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|June 16, 2009
PubMed

Insights

Systemic lupus erythematosus patients on long-term steroids may develop aortic dissection and annulo-aortic ectasia due to myxomatous degeneration. Aortic root replacement is a viable treatment for severe aortic regurgitation in these cases.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Surgical Pathology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
  • Long-term steroid therapy is a common treatment for SLE.
  • Steroid-induced complications can affect various organ systems.

Observation:

  • A 31-year-old male SLE patient on long-term steroids presented with asymptomatic aortic dissection and annulo-aortic ectasia.
  • Severe aortic regurgitation was detected via echocardiogram.
  • Magnetic resonance imaging confirmed the aortic abnormalities.

Findings:

  • Aortic root replacement surgery was successfully performed.
  • Histological examination of the aortic wall revealed myxomatous degeneration of the media.
  • The patient recovered well, requiring temporary hemodiafiltration.

Implications:

  • This case highlights a rare cardiovascular complication of long-term steroid use in SLE.
  • Myxomatous degeneration may be an underlying mechanism for aortic pathology in this context.
  • Early detection and surgical intervention are crucial for managing such severe aortic conditions.

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