Saccular Thoracoabdominal Aneurysms in Systemic Lupus Erythematosus

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Systemic lupus erythematosus (SLE) is an autoimmune disease with potential cardiovascular complications.
• Aortic aneurysms, though rare in SLE, represent a serious, potentially life-threatening condition.
• Inflammatory aortitis can be a manifestation of SLE, increasing aneurysm risk.

Observation:

• A 59-year-old male with a history of SLE presented with symptomatic saccular thoracoabdominal aneurysms.
• The patient had two distinct aneurysm locations in the thoracoabdominal aorta.
• Surgical intervention involved resection of the aneurysms and placement of silver-coated tube grafts.

Findings:

• Surgical pathology confirmed lymphoplasmacytic aortitis as the cause, with no infectious agents identified.
• This represents the first reported case of double saccular thoracoabdominal aneurysms associated with lupus-induced inflammatory aortitis.
• The findings underscore a unique presentation of vascular involvement in SLE.

Implications:

• Selective screening for aortic disease is recommended in SLE patients, particularly those with additional cardiovascular risk factors.
• Early detection and management of aortic complications in SLE can improve patient outcomes.
• This case expands the understanding of the spectrum of vascular manifestations in systemic lupus erythematosus.