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Systemic and cerebral vasculitis coexisting with disseminated coagulopathy in systemic lupus erythematosus associated
J T Lie1, S Kobayashi, Y Tokano
1Department of Pathology, University of California Davis Medical Center, Sacramento 95817, USA.
Insights
Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) can cause serious complications. This case highlights the rare coexistence of vasculitis and coagulopathy in a patient with both SLE and APS, leading to fatal stroke and myocardial infarction.
Area of Science:
- Rheumatology
- Vascular Medicine
- Pathology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by vasculitis.
- Antiphospholipid syndrome (APS) is an autoimmune disorder associated with thrombosis.
- Both SLE and APS can lead to life-threatening complications.
Observation:
- A 60-year-old woman presented with coexisting SLE and APS.
- The patient experienced systemic and cerebral vasculitis.
- Disseminated coagulopathy was also noted.
Findings:
- The patient suffered a fatal stroke and myocardial infarction.
- This combination of SLE, APS, vasculitis, and coagulopathy is rarely documented.
- The case illustrates a severe manifestation of overlapping autoimmune conditions.
Implications:
- Highlights the potential for severe, life-threatening complications when SLE and APS overlap.
- Emphasizes the need for vigilance in diagnosing and managing coexisting vasculitis and coagulopathy in these patients.
- Underscores the importance of understanding the distinct yet overlapping vasculopathies in SLE and APS.
Abstract:
Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are closely related, but each has it own characteristic vasculopathy: vasculitis in SLE and thrombosis in APS, and either may be a serious or life threatening complication. When a patient has SLE associated with APS, systemic and cerebral vasculitis may coexist with disseminated coagulopathy. We report this complication in a 60-year-old woman who died from stroke and myocardial infarction, an occurrence seldom documented in the literature.