Rheumatology International

, Volume 38, Issue 12, pp 2329–2335 | Cite as

Systemic lupus erythematosus and antineutrophilic cytoplasmic antibody-associated vasculitis overlap syndrome complicated by subarachnoid hemorrhage: case-based review

  • Ciril KhorolskyEmail author
  • Andrew Castellano
  • David Comstock
  • Nooshin K. Brinster
  • Sein Y. See
  • Bruce F. Garner
Cases with a Message


Systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) overlap syndrome is an inflammatory disorder with a mixed presentation that is characterized by clinical features of both SLE and AAV. Although renal disease predominates, any organ system in the body may be affected. Neurologic manifestation in patients with SLE–AAV overlap syndrome is rare and has only been previously documented as cerebral ischemia. We report a patient with SLE–AAV overlap syndrome diagnosed based on clinical, serologic and biopsy-proven histologic findings who presented with subarachnoid hemorrhage (SAH) secondary to ruptured right anterior cerebral artery aneurysm. To the authors’ knowledge, this is the first reported case of SLE–AAV overlap syndrome diagnosed in a patient with a SAH due to an intracranial aneurysm. Neurologic involvement in patients with SLE–AAV overlap syndrome is uncommon and has not been well-studied. Clinicians who encounter patients with neurologic signs that present with symptoms and a serologic profile that correspond to both SLE and AAV criteria, should consider the association between SLE–AAV overlap syndrome and a hemorrhagic stroke, specifically SAH.


Subarachnoid hemorrhage Lupus ANCA-associated vasculitis Overlap syndrome 


Author contributions

All authors assisted in data extraction, data analysis and literature review, and wrote significant sections of the paper.


No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Written informed consent was obtained from the patient for publication of this case study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MedicineNYU Langone HealthNew YorkUSA
  2. 2.Department of PathologyNYU Langone HealthNew YorkUSA
  3. 3.Department of NephrologyNYU Langone HealthNew YorkUSA
  4. 4.Department of RheumatologyNYU Langone HealthNew YorkUSA

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