Superior vena cava syndrome caused by systemic lupus erythematosus in a patient with longstanding rheumatoid arthritis.
Superior vena cava syndrome is mostly related to a malignant process, but many different benign causes have also been described. We report a patient with longstanding classic rheumatoid arthritis (RA), who developed a superior vena cava syndrome due to mediastinal lymphadenopathy. At that time she also fulfilled the ARA criteria for systemic lupus erythematosus (SLE). Histological examination of a lymph node biopsy revealed necrosis, hematoxylin bodies and LE cells, while a great amount of amorphous proteinaceous material was seen positive with immunofluorescence for IgG, IgM and complement (C3 and Clq). A diagnosis of superior vena cava syndrome due to mediastinal lymphadenopathy in a patient with SLE which had evolved from longstanding RA was established.
van den Brink
H
H
Department of Rheumatology, Slotervaart Hospital, Amsterdam, The Netherlands.
Vroom
T M
TM
van de Laar
M A
MA
van Soesbergen
R M
RM
van der Korst
J K
JK
D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008482:Mediastinum; D008875:Middle Aged; D013479:Superior Vena Cava Syndrome / Q000209:etiology*