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Int J Clin Exp Pathol 2013;6(2):273-280

Original Article
Pathologic diagnosis of spontaneous splenic rupture in
systemic lupus erythematosus

Ning Li, Jun C Wang, Ming H Zhu, Jia Y Wang, Xue L Fu, Jie R Zhou, Song G Zheng, Jie Han, Paul Chan

Department of Rheumatology, Shanghai East Hospital, Tongji University, Shanghai, China; Department of Pathology,
Shanghai East Hospital, Tongji University, Shanghai, China; Department of Pathology, Shanghai Chang
Hai Hospital, The Secondary Army Medical College, Shanghai, China; Division of Rheumatology & Immunology,
Department of Medicine, University of Southern California; Department of Medicine, Wan Fang Hospital, Taipei
Medical University, Taipei City, Taiwan. *Equal contributors.

Received October 23, 2012; Accepted December 3, 2012; Epub January 15, 2013; Published February 1, 2013

Abstract: Systemic lupus erythematosus (SLE) is a common autoimmune disease that involved multiple organ systems.
Diagnosis is usually not difficult. However, SLE involved spleen with spontaneous rupture is a rare condition
that has been only 5 cases reported previously; and no definite pathologic diagnosis has been reported. We present
the case of a 54 year-old white American woman who had SLE for 10 years with multiple immunosuppressive agents
treatment at stable condition. She had acute abdomen presented to the emergency department and received timely
surgical treatment which confirmed she had spontaneous spleen rupture (SSR). Detailed pathologic study, with control
of a traumatic rupture spleen of almost the same age and sex, revealed marked congestion of the red pulp and
atrophy of white pulp notified in the SLE spleen. Congestion of red pulp may be the cause of SSR in the SLE spleen.

Keywords: Systemic lupus erythematosus, spleen, spontaneous rupture

Address all correspondence to:
Dr. Jie Han
Department of Rheumatology, Shanghai East Hospital
Tongji University, Shanghai, China. 150, Ji Mo Road
Shanghai, China 200120.
E-mail: hjgj85528@yahoo.com.cn;

Dr. Paul Chan
Department of Medicine
Wan Fang Hospital, Taipei Medical University
111, Hsing-Lung Road, Section 3, Wen-Shan District
Taipei City, Taiwan 116.
Phone: 886 229307930 ext 2815, 2817; Fax: 886 2 29339378
E-mail: chanpaul@w.tmu.edu.tw