Open AccessPulseless systemic lupus erythematosus: A rare presentation
Author(s) -
Preema Sinha,
Rohit Kothari,
Arun Hegde,
Prateek Prateek
Publication year - 2021
Publication title -
indian dermatology online journal
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2249-5673
pISSN - 2229-5178
DOI - 10.4103/idoj.idoj_187_20
Subject(s) - medicine , anti nuclear antibody , presentation (obstetrics) , physical examination , systemic lupus erythematosus , brachial artery , radiology , lupus erythematosus , dermatology , cardiology , surgery , disease , pathology , autoantibody , antibody , immunology , blood pressure
Vascular disease is frequent in patients with systemic lupus erythematosus, which can be related to the disease process, or can develop as an accompanying co-morbidity and represents the most frequent cause of death in established disease. However, at times the presentations can be uncommon and subtle, and warrants a thorough examination both clinically and radiologically. We report a case of a young female with photosensitive malar rash, oral ulcers, intermittent fever with joint pains, history of two abortions, and unilateral absent radial and brachial artery pulses on clinical examination. The evaluation revealed positive antinuclear antibody (4+), anti-Smith antibody (2+), direct Coomb's test (2+), and antiphospholipid antibody panel was negative. Color doppler flow imaging of right upper limb (arterial) revealed irregular wall thickening with a narrow lumen and mildly reduced peak systolic volume. Computed tomography aortogram revealed wall thickening and luminal narrowing involving the entire length of the right brachial and radial artery. We report this case for its rarity and unique presentation of medium vessel vasculopathy.