Department of Trauma & Orthopaedics, Imperial College Healthcare NHS Trust, London, UK
Department of General and Upper GI Surgery, Aneurin Bevan University Health Board, Newport, Wales, UK.
BMJ Case Rep. 2022 Nov 29;15(11):e251953. doi: 10.1136/bcr-2022-251953.
Segmental involvement of medium-sized vessels are lesser-known manifestations of systemic lupus erythematosus (SLE) vasculopathy. Medium vessel vasculopathy and peripheral vascular disease (PVD) mimicking manifestations of SLE, although rare, have been reported, particularly in Asian women mostly under the age of 30 years. This is due to metabolic disadvantages in their ethnicity, with high incidence of insulin resistance and resulting metabolic syndrome, leading to lower high-density lipoprotein cholesterol levels, higher triglyceride levels and small dense low-density lipoprotein, increased proinflammatory cytokines, endothelial dysfunction and procoagulant tendency. Owing to the longer duration of the disease with the simultaneous use of steroids, vessels are often affected. SLE may also present with thyroid manifestations against a background of a proinflammatory immune state, where autoimmune thyroid diseases, such as Hashimoto's thyroiditis, may coexist. Here, we describe the case of a young woman who presented with progressive shortness of breath, right leg pain and cough with amenorrhoea and was diagnosed with SLE.
节段性中型血管受累是系统性红斑狼疮（SLE）血管病变不太为人所知的表现。中型血管血管病和外周血管疾病（PVD）模仿 SLE 的表现，尽管很少见，但已有报道，尤其是在亚洲女性中，大多数年龄在 30 岁以下。这是由于她们种族的代谢劣势所致，胰岛素抵抗和由此产生的代谢综合征发病率高，导致高密度脂蛋白胆固醇水平降低、甘油三酯水平升高和小而密的低密度脂蛋白、促炎细胞因子增加、内皮功能障碍和促凝倾向。由于疾病持续时间较长，同时使用类固醇，血管经常受到影响。SLE 也可能在炎症免疫状态的背景下出现甲状腺表现，此时可能同时存在自身免疫性甲状腺疾病，如桥本甲状腺炎。在这里，我们描述了一位年轻女性的病例，她出现进行性呼吸困难、右腿疼痛和咳嗽伴闭经，并被诊断为 SLE。
