Symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus: special consideration for renal vein thrombosis.
OBJECTIVE
To evaluate the prevalence of symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus (SLE), and to evaluate the frequency and the risk factors associated with renal vein thrombosis in those patients.


METHODS
Fifty-four patients with SLE, 51 (94.4%) females, were involved in this study. All of them were submitted for abdominal sonography, chest X-ray, echocardiography, and Doppler of renal, abdominal and lower limb veins, with examination of data on clinical and laboratory profile. Abdominal CT, brain MRI, MRI both hips, CT chest and pulmonary scintigraphy were used when needed.


RESULTS
Sixteen patients (29.6%) were diagnosed with symptomatic thrombotic events. Eight patients had more than one type of thrombosis. Two patients (3.7%) were diagnosed by Doppler as having renal vein thrombosis (RVT). This was confirmed by abdominal CT. One of them presented with nephrotic syndrome, graded by renal biopsy as World Health Organization (WHO) class V, and had positive anticardiolipin antibodies (ACL). The other patient had RVT and inferior vena cava (IVC) thrombosis, nephrotic syndrome, positive ACL, and died before renal biopsy was performed. Both of them were without history of peripheral thrombotic events. One patient was diagnosed with IVC thrombosis, lupus nephritis grade II, positive ACL, and diagnosed by abdominal CT. One patient was diagnosed with portal vein thrombosis and had positive ACL. One patient with retinal vessel thrombosis and positive ACL. Four patients had deep vein thrombosis (DVT). Recurrent miscarriages were reported in 4 patients (7.4%), skin ulcerations in 3 (5.6%), avascular necrosis of the hips in 4 (7.4%), stroke in 1 (1.9%), and pulmonary hypertension in 2 patients (3.7%).


CONCLUSIONS
Sixteen SLE patients (29.6%) were diagnosed with symptomatic thrombotic events. RVT was detected in 2 patients representing 3.7% of all patients, and 12.5% of patients with thrombosis. Both patients with RVT presented with nephrotic syndrome.
Shahin
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AA
Department of Rheumatology and Rehabilitation, 453 Al-Ahram Street, Al-Ahram, Giza, Egypt. rughe@rusys.eg.net
Mostafa
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H
Sami
H
H
Shahin
H A
HA
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001706:Biopsy; D003952:Diagnostic Imaging; D004534:Egypt; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000473:pathology; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000473:pathology; D012082:Renal Veins / Q000473:pathology; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis* / Q000473:pathology; D014682:Vena Cava, Inferior / Q000473:pathology
D017153:Antibodies, Anticardiolipin