Abstract
Systemic lupus erythematosus (SLE) is a complex heterogeneous autoimmune disease with a wide variety of clinical and serological manifestations that may affect any organ. Vasculitis prevalence in SLE is reported to be between 11 % and 36 %. A diverse clinical spectrum, due to inflammatory involvement of vessels of all sizes, is present. Even though cutaneous lesions, representing small vessel involvement, are the most frequent, medium and large vessel vasculitis may present with visceral affection, with life-threatening manifestations such as mesenteric vasculitis, pulmonary hemorrhage, or mononeuritis multiplex, with detrimental consequences. Early recognition and an appropriate treatment are crucial. Recent studies have shown that vasculitis in patients with SLE may present different clinical forms based on the organ involved and the size of the affected vessel. It is noteworthy that the episodes of vasculitis are not always accompanied by high disease activity. Recent articles on this topic have focused on new treatments for the control of vascular disease, such as biological therapies such as Rituximab and Belimumab, among others.
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Leonor Adriana Barile-Fabris, María Fernanda Hernández-Cabrera and Jorge Alberto Barragán- Garfias declare that they have no conflict of interest.
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Key Points
• Vasculitis in SLE may involve vessels of any size, but small vessel involvement predominates.
• Visceral vasculitis is associated with increased mortality.
• There is a close association between the presence of vasculitis and lupus activity.
• The presence of vasculitis in critical organs or systems (pancreas, kidney, central nervous system) requires aggressive treatment with high-dose steroids and immunosuppressive agents (cyclophosphamide).
This article is part of the Topical Collection on Vasculitis
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Barile-Fabris, L., Hernández-Cabrera, M.F. & Barragan-Garfias, J.A. Vasculitis in Systemic Lupus Erythematosus. Curr Rheumatol Rep 16, 440 (2014). https://doi.org/10.1007/s11926-014-0440-9
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DOI: https://doi.org/10.1007/s11926-014-0440-9
Keywords
- Systemic lupus erythematosus
- Small vessel vasculitis
- Medium vessel vasculitis