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Giant coronary aneurysm in a patient with systemic lupus erythematosus

Hiroyuki Suzuki1, Yoshihide Fujigaki, Masashi Mori

  • 1The First Department of Medicine, Hamamatsu University School of Medicine. hirosuzu@hama-med.ac.jp

Internal Medicine (Tokyo, Japan)
|August 19, 2009
PubMed

Insights

Coronary artery aneurysms are rare in patients with systemic lupus erythematosus (SLE). This case highlights the need for screening coronary lesions in SLE management, as aneurysms can develop even during inactive disease stages.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pathology

Background:

  • Coronary aneurysms are uncommon in systemic lupus erythematosus (SLE).
  • Etiology is often confirmed postmortem.
  • Previous history of aortic aneurysm and dissection (AAA/TAA) was noted.

Observation:

  • A giant coronary aneurysm with multiple stenotic segments was identified in an SLE patient.
  • The patient had a history of AAA/TAA.

Findings:

  • Surgical resection of the aneurysm and coronary artery bypass grafting were successful.
  • Histology revealed severe medial damage and inflammatory cell infiltration, confirming arteritis as the cause.
  • The aneurysm likely developed during a long, inactive SLE phase.

Implications:

  • This case underscores the importance of screening for coronary artery lesions in SLE patients.
  • Arteritis-induced coronary aneurysms can occur in SLE, even in clinically inactive disease.
  • Proactive cardiovascular surveillance is crucial for managing SLE patients.

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