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A case of systemic lupus erythematosus presenting as malignant hypertension with hypertensive retinopathy

Jung-Yoon Choe1, Sung-Hoon Park, Ji-Young Kim

  • 1Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

The Korean Journal of Internal Medicine
|September 11, 2010
PubMed

Insights

Systemic lupus erythematosus (SLE) can cause hypertension, a serious issue linked to early mortality. This case highlights rare malignant hypertension in an SLE patient without initial signs of antiphospholipid antibody syndrome or kidney disease.

Area of Science:

  • Cardiology
  • Rheumatology
  • Nephrology

Background:

  • Cardiovascular abnormalities are common in systemic lupus erythematosus (SLE).
  • Hypertension affects 14-58.1% of SLE patients, increasing mortality risk.
  • Hypertension in SLE is linked to renal disease and lupus treatments.

Observation:

  • This report details a case of a patient diagnosed with SLE and malignant hypertension.
  • The patient presented with hypertensive retinopathy, a sign of severe hypertension.
  • Notably, the initial presentation lacked clinical evidence of antiphospholipid antibody syndrome or hypertensive nephropathy.

Findings:

  • The case illustrates a rare occurrence of malignant hypertension in SLE.
  • It underscores that malignant hypertension can manifest in SLE patients even without concurrent antiphospholipid antibody syndrome or significant kidney involvement.
  • Hypertensive retinopathy was a key clinical sign in this presentation.

Implications:

  • This case emphasizes the importance of monitoring for severe hypertension and its complications in SLE patients.
  • It suggests that malignant hypertension should be considered in the differential diagnosis of SLE patients with severe hypertensive retinopathy, irrespective of typical associated conditions.
  • Further research may be warranted to understand the specific mechanisms and risk factors for malignant hypertension in SLE patients presenting atypically.

Keywords:
Hypertension, malignantLupus erythematosus, systemic

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