Lupus aortitis and aneurysm: Case report and review of the literature

Lupus aortic vasculitis with aneurysm formation is an ill-defined, rare, and potentially fatal complication of systemic lupus erythematosus (SLE). In the small number of reported cases, patients have presented with arteritis coexistent with atherosclerosis. Because atherosclerosis is commonly associated with aneurysm formation, it is difficult to separate its contribution to the aneurysm formation from that of lupus arteritis. Furthermore, the role of standard chemotherapy is unclear. We report a case of a 37-year-old man with a 3-year history of SLE who developed an abdominal- aortic aneurysm associated exclusively with arteritis. Aortograms demonstrated aneurysm formation despite previous standard cytotoxic therapy. Successful surgical repair was performed. The effectiveness of cytotoxic therapy for SLE in preventing and treating lupus-related aneurysms needs to be evaluated.