Cardiovascular involvement in systemic lupus erythematosus: An autopsy study of 27 patients in India

• Main Authors: Panchal L, Divate Smita, Vaideeswar P, Pandit S
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2006-01-01
• Series: Journal of Postgraduate Medicine
• Subjects: Systemic lupus erythematosus; cardiovascular; autopsy; mortality
• Online Access: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2006;volume=52;issue=1;spage=5;epage=10;aulast=Panchal

<b>Background: </b> Although cardiovascular disease (CVD) is recognized as a leading cause of death in patients with systemic lupus erythematosus (SLE) in western countries, there is hardly any data regarding Indian subjects with SLE. <b> Aims:</b> To determine the incidence of cardiac abnormalities and vascular lesions at autopsy and to assess their contribution to the mortality in patients with SLE <b> Settings and Design:</b> Retrospective retrieval of reports of autopsies performed on 35 patients with SLE over a 11 year period and analysis of 27 cases with cardiac and/or vascular lesions. <b> Materials and Methods:</b> Gross and microscopic features in 27 autopsies were analyzed with special attention to the heart and the vasculature of all organs. Findings were correlated with clinical features and ante-mortem investigations. Their contribution towards mortality was assessed. <b> Results:</b> Valvar lesions were the commonest cardiac lesions noted with non-bacterial thrombotic endocarditis in nine (33.33&#x0025;), valvar thickening in two (7.41&#x0025;), Libman-Sacks endocarditis and infective endocarditis in one (3.70&#x0025;) each. Myocarditis and myocardial scarring were seen in 10 (37.03&#x0025;) and seven (25.92&#x0025;) cases, respectively. Fibrinous pericarditis was noted in seven (25.92&#x0025;). Thromboses/ embolism, vasculitis and severe coronary atherosclerosis were seen in nine (33.33&#x0025;), five (18.52&#x0025;) and one (3.70&#x0025;) subjects, respectively. Renal disease [13, 48.14&#x0025;] and cardiovascular manifestations [8, 29.62&#x0025;] were the leading causes of death in our patient population. <b> Conclusion:</b> CVD contributes significantly to the mortality in patients with SLE in India. It is second only to renal disease in this regard