title: Cerebral haemorrhage in a patient with systemic lupus erythematosus and vasculitis treated with intravenous immunoglobulins for a long-time and in absence of other risk factors.
abstract: Central nervous system involvement has been reported in up to 60% of patients with systemic lupus erythematosus (SLE). Cerebral vasculitis in SLE is rare and its incidence in post-mortem studies has been documented from 7% to 15% of cases. Cerebral haemorrhage is described in 0.4-7% of cases and it is usually due to inherent or iatrogenic factors (e.g., arterial hypertension, thrombocytopenia or anticoagulation). We report a case of cerebral haemorrhage in a patient with SLE and histologically proven cerebral vasculitis, leading to the death of the patient within 12 months. In the patient presented herein, the cerebral haemorrhage was not correlated to possible known causes of these events, apart from the long-term use of intravenous immunoglobulins. The authors discuss the possible role of intravenous immunoglobulin therapy as pathogenetic factor for cerebral vasculitis in this patient.
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, Pathological Anatomy Section, University of Siena, Italy. chiara.giannitti@libero.it
authors.forename: C
authors.initials: C
authors.lastname: Giannitti
authors.forename: A
authors.initials: A
authors.lastname: Cerase
authors.forename: C
authors.initials: C
authors.lastname: Miracco
authors.forename: A
authors.initials: A
authors.lastname: Fioravanti
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000188:drug therapy*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors