Mediterr J Rheumatol 2020;31(2):216-9
Periaortitis and diffuse subendocardial vasculitis in a patient with systemic lupus erythematosus – Lupus flare or a coexisting disease?
Authors Information

1.Department of Rheumatology, Asklepieion General Hospital, Athens, Greece

2. Department of Cardiology, Asklepieion General Hospital, Athens, Greece

3. Department of Radiology, Asklepieion General Hospital, Athens, Greece

4. Cardiac MRI Unit, Mediterraneo Hospital, Athens, Greece


Systemic lupus erythematosus (SLE) is a heterogeneous disease with a broad spectrum of clinical manifestations. Periaortitis is a rare disorder which may manifest isolated or in association with other autoimmune diseases, including SLE. Another rare, yet severe cardiovascular manifestation of lupus is diffuse subendocardial vasculitis (DSV), which should be suspected in patients presenting with myocardial hypokinesis, impaired ejection fraction and normal coronary angiography. Cardiovascular Magnetic Resonance (CMR) imaging is crucial to distinguish between DSV and lupus myocarditis, which should also be included in the differential diagnosis.

Herein, we describe a case of a female patient with pre-existing SLE, who presented with both periaortitis and DSV, and discuss the diagnostic challenges associated with these rare manifestations.


This work is licensed under a Creative Commons Attribution 4.0 International License.

©Gioti O, Theotikos E, Lazarini A, Triantafyllis AS, Balanika A, Boutsikou M, Tsinivizov P, Fanouriakis A, Elezoglou A.