Abstract
A 30-year-old woman with a 15-year history of systemic lupus erythematosus (SLE) was admitted to our hospital with sudden anterior chest pain. Her condition had been controlled by steroid therapy for 15 years. She initially received a diagnosis of pericarditis because she had a history of 2 episodes of pericarditis. However, her chest pain continued, and enhanced computed tomography was performed 8 days after admission which demonstrated Stanford type A aortic dissection. We performed graft replacement of the ascending and arch aorta as an emergency operation under deep hypothermic selective cerebral perfusion. The patient was discharged uneventfully on the 30th postoperative day. A histological study of the aortic wall demonstrated that inflammatory cells infiltrated the media and obliterative endarteritis of the vasa vasorum, but there was no evidence of arteriosclerosis. These findings were consistent with a diagnosis of vasculitis. There are some reports regarding aortic dissection in SLE patients; however, aortic dissection due to vasculitis is extremely rare.
