Systemic lupus erythematosus complicated by disseminated intravascular coagulation: the role of serum soluble cell surface markers.

We describe a 31-year-old Japanese female patient with systemic lupus erythematosus (SLE), who developed disseminated intravascular coagulation (DIC), fever, erythema on the hands, and aphthous stomatitis despite the absence of circulating anticoagulant. Since no other cause for DIC besides SLE could be demonstrated, she was treated with prednisolone and anticoagulants, which rapidly corrected the DIC as well as the other manifestations of SLE. During the episode of DIC, elevated serum anti-DNA antibody titers and decreased serum complement concentrations were not observed. In contrast, the serum concentration of soluble CD8 (sCD8) paralleled SLE disease activity. In addition, the concentration of plasma thrombomodulin was also increased. These observations suggest that the serum concentration of sCD8 is related to the clinical aspects of SLE, and that vasculitis might contribute to the development of SLE-associated DIC.