Membranous obstruction of the inferior vena cava and systemic lupus erythematosus.
A 37-year-old woman who presented with systemic lupus erythematosus was found to have a membranous obstruction of the inferior vena cava above the hepatic veins, with an extensive collateral circulation. The obstruction was relieved by a renal vein-right atrial interposition graft, and this was followed by disappearance of the anti-nuclear and anti-DNA antibodies. We postulate that the systemic lupus erythematosus might have been provoked by life-long immune stimulation due to bowel-derived antigens bypassing the hepatic reticuloendothelial system and reaching the systemic circulation, or by immune hyperreactivity associated with the abnormal abdominal venous circulation.
D000328:Adult; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000209:etiology*; D011859:Radiography; D014652:Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging