Lupus vasculitis complicated by a retroperitoneal hematoma: A case report

Context: Vasculitis associated with systemic lupus erythematosus (SLE) is a rare but potentially serious complication that may involve blood vessels of various calibers. Spontaneous retroperitoneal hematoma represents an exceptional manifestation of this vascular involvement, and its diagnosis relies largely on imaging.
Case Presentation: A 36-year-old female patient presented to the emergency with afebrile right-sided low back pain associated with marked pallor. An abdominal CT angiography revealed multiple confluent right-sided retroperitoneal hematomas associated with a pseudoaneurysm arising from the ipsilateral renal artery. The patient subsequently underwent conventional arteriography, which demonstrated a thin and irregular appearance of the ipsilateral renal artery, consistent with large-vessel vasculitis. 
Conclusion: This case highlights the crucial role of imaging, particularly CT angioscanner, in the diagnosis of rare vascular complications of systemic lupus erythematosus. Early identification of a vasculitis-related retroperitoneal hematoma allows prompt therapeutic management and improves patient outcomes.