Aortic aneurysm and dissection in systemic lupus erythematosus

Aortic aneurysm and dissection are rare complications of systemic lupus erythematosus (SLE). The incidence, etiology, risk factors, and outcomes of this entity were largely unknown.

The study materials were based on the publications of aortic aneurysm or dissection due to SLE published between 2000 and 2017.

A total of 36 articles reporting a single case or case series involving 40 patients were collected. The patients showed an absolute female dominance at a mean aneurysm age of 44.6 years. Steroid use was 13.3 ± 9.4 years prior to admission for management of aortic aneurysm or dissection. Aortic aneurysm occurred more commonly in abdominal than other segments of the aorta, whereas aortic dissection did not show any location predilection. Patients with open aortic operations showed a higher mortality rate than other groups; however, no statistical significance was reached. Interventional therapy was minimally invasive, but postinterventional endoleaks were a concerning problem.

SLE patients had significant risks for developing aortic aneurysm and dissection. Hypertension, long-term steroid use, and aortic pathological changes related to SLE seemed to be predominant risk factors for the occurrence of aortic aneurysm and dissection. Upon diagnosis, a surgical, interventional, or hybrid treatment should be performed to prevent severe sequelae and sudden deaths.