[Hemorrhagic shock revealing multiple digestive microaneurysms in a patient with systemic lupus erythematosus: Case report and literature review]

Rev Med Interne. 2017 Jan;38(1):56-60. doi: 10.1016/j.revmed.2016.02.020. Epub 2016 Mar 29.
[Article in French]

Abstract

Introduction: The vascular disorders in systemic lupus erythematosus (SLE) result from various mechanisms and presentations (inflammatory disease or vasculitis, atherosclerosis).

Case report: We report on a 34-year-old man with cutaneous, articular, neurological and nephrologic SLE. He presented with catastrophic haemorrhage on microaneurysm rupture of the left hepatic artery. After blood transfusions and immunosuppressive treatments, his condition improves.

Conclusion: Uncommon complication in SLE patients, digestive vasculitis with microaneurysms may occur as in polyarteritis nodosa. In the literature, we identified 10 additional cases of hepatic microaneurysms in SLE patients. The main issue is an earlier diagnosis in order to give appropriate treatment and improve prognosis.

Keywords: Choc hémorragique; Hemorrhagic shock; Lupus érythémateux systémique; Micro-anévrismes; Microaneurysms; Systemic lupus erythematosus; Vascularite; Vasculitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Digestive System Diseases / complications*
  • Digestive System Diseases / diagnosis
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Male
  • Microaneurysm / complications*
  • Microaneurysm / diagnosis
  • Shock, Hemorrhagic / diagnosis
  • Shock, Hemorrhagic / etiology*