HEPATIC INFARCTION IN A HEMODIALYSIS PATIENT WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Hepatic infarction remains a rare and dramatic presentation of an acut e abdomen in patients with systemic lupus erythematosus, It can be rec ognized preoperatively only with a high index of suspicion, Imaging st udies such as abdominal computed tomography may aid in making the diag nosis, The tendency for thrombosis in these patients often can be asso ciated with the presence of circulating anticoagulants from a group of antiphospholipid antibodies. The finding of lupus anticoagulant or an ticardiolipin antibodies can help identify those patients more prone t o thrombotic episodes, although at present it cannot be assumed that t hese antibodies cause the thromboses. Hemodialysis patients are said t o have a decreased tendency for vascular thrombosis, but this may not be true in the presence of circulating antiphospholipid antibodies. We report a case of histologically documented hepatic infarction seconda ry to thrombosis in an end-stage renal disease patient on hemodialysis with systemic lupus erythematosus and a circulating lupus anticoagula nt. (C) 1995 by the National Kidney Foundation, Inc.