Pathologic diagnosis of spontaneous splenic rupture in systemic lupus erythematosus

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.