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Occlusive vasculopathy in systemic lupus erythematosus. Association with anticardiolipin antibody

S G Greisman1, R S Thayaparan, T A Godwin

  • 1Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY 10019.

Archives of Internal Medicine
|February 1, 1991
PubMed

Insights

Systemic lupus erythematosus patients with antiphospholipid antibodies can experience catastrophic vascular occlusions. Treatment may benefit from plasmapheresis and anticoagulation, not immunosuppressants.

Area of Science:

  • Rheumatology
  • Immunology
  • Pathology

Background:

  • Systemic lupus erythematosus (SLE) and antiphospholipid antibodies (aPL) are associated with vascular events.
  • Sudden occlusion of multiple blood vessels can occur in affected patients.

Observation:

  • Two cases of SLE with high-titer aPL presented with acute, widespread, non-inflammatory visceral vascular occlusions.
  • Histopathology differentiated these cases from typical SLE vasculitis.

Findings:

  • The observed vascular occlusions were non-inflammatory.
  • High-titer antiphospholipid antibodies were present in both patients.

Implications:

  • Steroids and immunosuppressants may have limited efficacy due to the non-inflammatory nature of the occlusion.
  • Plasmapheresis combined with anticoagulant therapy is suggested as a potential treatment strategy.

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