Pulseless Systemic Lupus Erythematosus

Abstract

Vascular disease is frequent in patients with systemic lupus erythematosus, which can be related to the disease process, or can develop as an accompanying co-morbidity and represents the most frequent cause of death in established disease. However, at times the presentations can be uncommon and subtle, and warrants a thorough examination both clinically and radiologically. We report a case of a young female with photosensitive malar rash, oral ulcers, intermittent fever with joint pains, history of two abortions, and unilateral absent radial and brachial artery pulses on clinical examination. The evaluation revealed positive antinuclear antibody (4+), anti-Smith antibody (2+), direct Coomb's test (2+), and antiphospholipid antibody panel was negative. Color doppler flow imaging of right upper limb (arterial) revealed irregular wall thickening with a narrow lumen and mildly reduced peak systolic volume. Computed tomography aortogram revealed wall thickening and luminal narrowing involving the entire length of the right brachial and radial artery. We report this case for its rarity and unique presentation of medium vessel vasculopathy.

Pharmacists’ role in multidisciplinary diagnosis and treatment in adverse reactions: A case report of interferon alfa-2b induced severe lupus

“…In contrast to idiopathic SLE, there is no female or racial predilection for DILE, and the average age of presentation is older than that of idiopathic SLE, as corroborated by our patient being a middle-aged male. [12]…”

“…In contrast to idiopathic SLE, there is no female or racial predilection for DILE, and the average age of presentation is older than that of idiopathic SLE, as corroborated by our patient being a middleaged male. [12] According to previous literature, SLE onset and exacerbation might be associated with pathogen infection, notably viruses, alongside certain bacterial components that can also trigger activation of the immune system. [13] Laboratory screening for suspected viruses, including cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, and hepatitis C, was negative.…”