A case of subarachnoid hemorrhage due to a ruptured aneurysm with systemic lupus erythematosus and klinefelter syndrome

Abstract

We report a case of subarachnoid hemorrhage(SAH) due to ruptured aneurysm in the course of Klinefelter syndrome and systemic lupus erythematosus (SLE). The case was a 49-year-old male who suffered from SLE for 16 years. He noticed sudden severe headache and vomiting, and was admitted to our hospital. The CT scan revealed SAH. The cerebral angiography showed a saccular aneurysm of the anterior communicating artery and a stenotic lesion of the left middle cerebral artery. The patient underwent the neck clipping of the aneurysm and was discharged with no neurological deficits about 2 months after admission. The test for antiphospholipid antibodies was positive in his serum. This is the first report of a ruptured aneurysms in a patient with SLE and Klinefelter syndrome with antiphospholipid antibodies. These findings suggested that the aneurysm formation in SLE might be related to the antiphospholipid antibody and the chronic estrogen stimulation in Klinefelter syndrome might have affected the production of autoantibodies.