Stroke in systemic lupus erythematosus.
With improved control of the immunological phenomena of systemic lupus erythematosus, the epidemiology of this disease is changing. While both cardiac and neurological manifestations of systemic lupus erythematosus have been consistently described, there is increasing awareness of the need for general cardiovascular prevention in systemic lupus erythematosus. An excess of stroke is seen in systemic lupus erythematosus especially, in those cases with anticardiolipin antibodies. There is increasing evidence for the contributory role of other cardiovascular risk-factors, including hypertension, hyperlipidemia and inflammatory markers, to the epidemiology of stroke and recognition of the role of endothelial dysfunction may play in systemic lupus erythematosus. Therapeutic approaches currently rely on anticoagulation alone. This review suggest that the full panoply of stoke interventions, including antihypertensive therapy and lipid-lowering, should be applied in the case of stroke in systemic lupus erythematosus just as in atherosclerotic stroke.
Wierzbicki
Anthony S
AS
St.Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK. anthony.wierzbicki@kcl.ac.uk