Ten years' experience of aortic aneurysm associated with systemic lupus erythematosus.
BACKGROUND
aortic aneurysm is a rare but life-threatening cardiovascular complication in patients with systemic lupus erythematosus (SLE). The purpose of this study was to clarify the characteristic clinical features and the pathological mechanism of aneurysmal formation in these patients.


METHODS
among 429 patients operated on for abdominal aortic aneurysm (AAA) during the past 10 years, five cases with SLE were treated surgically. Their clinical data were reviewed, and the resected aneurysmal wall of the five patients was also examined histologically.


RESULTS
the mean age of the patients with SLE was 55 years, which was statistically younger than that of the other patients (mean 77 years, s.d. 7.9, p <0.05). They had received long-term corticosteroid therapy for the treatment of SLE for a mean of 23 years. Histologically, destruction of the medial elastic lamina was characteristic. Four patients had no complications in the postoperative follow-up period (mean 4 years), while the remaining patient died of rupture of a dissecting aneurysm two years after operation.


CONCLUSIONS
prolonged steroid therapy may play a major role in accelerating atherosclerosis, which can result in aortic aneurysmal enlargement, possibly together with primary aortic wall involvement and/or vasculitic damage in patients with SLE.
Ohara
N
N
Division of Vascular Surgery, Department of Surgery, Japan.
Miyata
T
T
Kurata
A
A
Oshiro
H
H
Sato
O
O
Shigematsu
H
H
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000784:Aortic Dissection / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology; D001025:Aortitis / Q000139:chemically induced; D001161:Arteriosclerosis / Q000139:chemically induced; D002423:Cause of Death; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013256:Steroids; D017539:Tunica Intima / Q000473:pathology
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D013256:Steroids