Ten years' experience of aortic aneurysm associated with systemic lupus erythematosus

Background: aortic aneurysm is a rare but life-threatening cardiovascular c omplication in patients with systemic lupus erythematosus (SLE). The purpos e 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. The ir clinical data were reviewed, and the resected aneurysmal wall of the fiv e patients was also examined histologically. Results: the mean age of the patients with SLE was 55 years, which was stat istically 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 treatm ent of SLE for a mean of 23 years. Histologically, destruction of the media l elastic lamina was characteristic. Four patients had no complications in the postoperative follow-up period (mean 4 years), while the remaining pati ent died of rupture of a dissecting aneurysm two years after operation. Conclusion: prolonged steroid therapy may play a major role bz accelerating atherosclerosis, which cart result in aortic aneurysmal enlargement, possi bly together with primary aortic wall involvement and/or vasculitic damage ill patients with SLE.