Systemic vascular lesions and prognosis in systemic lupus erythematosus.

The purpose of this paper is to show the relationship of systemic vascular lesions to the clinical manifestations and prognosis in SLE. Thirty-four autopsied cases of SLE formed the subject material for this study. Histopathological tissue studies were made on vascular lesions from almost all organs. Vascular lesions were separated into three groups according to the size of the involved vessel: 1) medium-sized artery (9 cases), 2) small artery (12 cases) and 3) (13 cases) without systemic vascular lesions. Vascular lesions were also separated into five groups (a) fibrinoid degeneration (10 cases), b) intimal thickening (6 cases), c) thrombosis (6 cases), d) sclerosis (7 cases) and e) (13 cases) without systemic vascular lesions. Patients with involvement of medium-sized arteries had a low female incidence, photosensitivity, and positive LE cell incidence, and the cause of death in these patients was cerebral vascular involvement. The cause of death in patients with vascular fibrinoid degeneration and thrombosis was mainly uremia, whereas patients with sclerosis more often died from infection. Regarding systemic vascular lesions in SLE, the prognosis for the patients with thrombosis and vascular involvement of medium-sized arteries was the most grave.