Digital Vascular Manifestations in S.L.E.: A Case Report and Review of Literature ‘for Prognostic Evaluation of Cardiovasc ular Manifestations in S.L.E.*

Abstract

SUMMARY: A young patient was seen at our Department of Vascular Surgery with secondary Raynaud’s disease of a short duration, characterised by digital ischaemia of upper and lower limbs. Family history was positive. Investigations revealed pre sence of collagen disease. The most likely diagnosis was Systemic Lupus Erythematosus. The patient was treated with steroids and responded well by clinical [loss of symptoms and gns) and laboratory parameters (Falling ESR, lowered C3 and improved digital circulation on doppler flow studies). Since the cardiovascular manifestations are prognostically important in the overall management, appropriate literature was reviewed and quoted here. DISCUSSION: SLE is a fairly uncommon illness affecting girls 5 times more than boys although the striking female predominance is not seen until after puberty. Before puberty, the ratio of girls to boys is lower, approximately 3:1 (1, 2). In the USA, the incidence is 4 times higher in the negroid population although the same predominance has not been seen in Africa (1). The incidence has recently risen most probably due to increased awareness and to improve diagnostic method& A recent Baltimore study showed the incidence to be 4.6 per 100,000 population per year (16).The clinical manifestations of SLE include weight loos rexia, malaise, fatigue and fever, however, often the fever is caused by a superimposed Generalized lymphadenophathy and hepatosplenomegaly may also be present(1).