J Rheum Dis.  2015 Apr;22(2):106-110. 10.4078/jrd.2015.22.2.106.

A Case of Massive Pulmonary Embolism in Systemic Lupus Erythematosus without Antiphospholipid Antibody

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. lyhcgh@korea.ac.kr

Abstract

Patients with systemic lupus erythematosus (SLE) are at an increased risk of developing thromboses with antiphospholipid antibodies (aPL). The presence of aPL is related to an increased risk of thrombotic events. However, thromboembolic events can occur in SLE patients without aPL, and pulmonary emboli are rarely reported manifestations of SLE without aPL. Here, we report on a case of massive pulmonary embolism in a 58-year-old woman with aPL-negative SLE. She presented with chest pain and dyspnea, and chest computed tomography (CT) and lung perfusion ventilation scans showed pulmonary thromboembolism. She was administered thrombolytic agents, heparin, and warfarin. Two months later, no remarkable residual thromboembolism was observed on chest CT.

Keyword

Pulmonary embolism; Systemic lupus erythematosus; Antiphospholipid antibodies

MeSH Terms

Antibodies, Antiphospholipid*
Chest Pain
Dyspnea
Female
Fibrinolytic Agents
Heparin
Humans
Lung
Lupus Erythematosus, Systemic*
Middle Aged
Perfusion
Pulmonary Embolism*
Thorax
Thromboembolism
Thrombosis
Tomography, X-Ray Computed
Ventilation
Warfarin
Antibodies, Antiphospholipid
Fibrinolytic Agents
Heparin
Warfarin

Figure

  • Figure 1. Spiral chest computed tomography showing pulmonary thromboembolism in the right pulmonary artery (A) and chest computed tomography showing the absence of remarkable residual thromboembolism (B).

  • Figure 2. Perfusion ventilation scintigraphy showing segmental perfusion defects in the right lung and normal tracer distribution in the left lung.


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