Author(s): Panchal L, Divate S, Vaideeswar P, Pandit SP
Abstract Share this page
Abstract BACKGROUND: 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. AIMS: To determine the incidence of cardiac abnormalities and vascular lesions at autopsy and to assess their contribution to the mortality in patients with SLE. SETTINGS AND DESIGN: 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. MATERIALS AND METHODS: 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. RESULTS: Valvar lesions were the commonest cardiac lesions noted with non-bacterial thrombotic endocarditis in nine (33.33\%), valvar thickening in two (7.41\%), Libman-Sacks endocarditis and infective endocarditis in one (3.70\%) each. Myocarditis and myocardial scarring were seen in 10 (37.03\%) and seven (25.92\%) cases, respectively. Fibrinous pericarditis was noted in seven (25.92\%). Thromboses/embolism, vasculitis and severe coronary atherosclerosis were seen in nine (33.33\%), five (18.52\%) and one (3.70\%) subjects, respectively. Renal disease [13, 48.14\%] and cardiovascular manifestations [8, 29.62\%] were the leading causes of death in our patient population. CONCLUSION: CVD contributes significantly to the mortality in patients with SLE in India. It is second only to renal disease in this regard.
This article was published in J Postgrad Med
and referenced in Journal of Clinical Case Reports