Systemic Lupus Erythematosus Presenting as Superior Vena Cava Syndrome Associated With Anticardiolipin Antibodies

Abstract

A case of systemic lupus erythematosus (SLE) presenting as superior vena cava syndrome is pre sented. This 19-year-old woman was admitted for head ache and swelling in her face and neck. Initial evaluation revealed that she had a superior vena cava syndrome. Thoracal computed tomography (CT) and intravenous digital substraction angiography demonstrated the occlu sion in the superior vena cava. ANA and antiDNA titers were high and anticardiolipin antibodies were positive. Along with immunosuppressive treatment, she had been administered intravenous streptokinase. To our knowl edge, no SLE patient presenting with such an unusual form has been described in the English literature.

Keywords

Key Words: Systemic lupus erythematosus Superior vena cava syndrome Anticardiolipin antibodies.

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References

Alarcon-Segovia D. , Deleze M. , Oria CV Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus: A prospective analysis of 500 consecutive patients. Medicine 1989;68:353-65.

Ostuni PA , Lazzarin P. , Pengo V. , Ruffatti A. , Schiavon F. , Gambari P. Renal artery thrombosis and hypertension in a 13 year old girl with antiphospholipid syndrome. Ann Rheum Dis 1990 ;49:184-7.

Mintz G. , Acevedo-Vázquez E. , Gutiérrez-Espinosa G. , Avelar-Garnica F. Renal vein thrombosis and inferior vena cava thrombosis in systemic lupus erythematosus. Arthritis Rheum 1984;27:539-44.

Cappell MS , Seibold JR Mesenteric thrombosis associated with anticardiolipin antibodies in a patient with systemic lupus erythematosus. Am J Gastroenterol 1992;82:520-2.

Love PE , Santoro SA Antiphospholipid antibodies: Anticardiolipin and lupus anticoagulant in systemic lupus erythematosus and in non-SLE disorders: Prevalence and clinical significance . Ann Intern Med 1990;112:682-98.

Ahman FR A reassessment of the clinical implications of the superior vena caval syndrome . J Clin Oncol 1984;2: 961-4.

Schowengerdt CG , Suyemoto R. , Main FB Granulomatous and fibrous mediastinitis. A review and analysis of 180 cases. J Thorac Cardiovasc Surg 1969;57:365-79.

Tan EM , Cohen AS , Fries JF , et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271-7.

Hasselaar P. , Derksen Rhwm , Blokzijl L. , et al. Risk factors for thrombosis in lupus patients. Ann Rheum Dis 1989;48: 933-40.

10.

Fauci AS , Hayne BF , Katz P. The spectrum of vasculitis. Ann Intern Med 1978;89:660-76.

11.

Greisman SG , Thayaparan RS , Godwin TA , Lockshin MD Occlusive vasculopathy in systemic lupus erythematosus: Association with anticardiolipin antibody . Arch Intern Med 1991;151:389-92.

12.

Herrera JL , Willis SM , Williams TH Successful streptokinase therapy of acute idiopathic superior vena cava thrombosis . Am Heart J 1981;102:1063-4.

13.

Gray BH , Olin JW , Graor RA , Young JR , Bartholomew JR , Ruschhaupt WF Safety and efficacy of thrombolitic therapy for superior vena cava syndrome . Chest 1991;99:54-9.

14.

De Jaegere PP , Arnold AA , Balk AH , Simoons ML Intracranial hemorrhage in association with thrombolytic therapy: Incidence and clinical predictive factors. J Am Coll Cardiol 1992 ;19:289-94.