scholarly journals Lupus Enteritis: An Uncommon Manifestation of Systemic Lupus Erythematosus as an Initial Presentation

2017 ◽  
Vol 08 (03) ◽  
pp. 134-136 ◽  
Author(s):  
Vishal Bodh ◽  
Ritesh Kalwar ◽  
Rajesh Sharma ◽  
Brij Sharma ◽  
Sanjay Mahajan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Autoimmune Disorder ◽  
Systemic Lupus ◽  
Protein Losing Enteropathy ◽  
Multiple Organs ◽  
Gluten Enteropathy ◽  
Lupus Enteritis ◽  
Intestinal Pseudo Obstruction

ABSTRACTSystemic lupus erythematosus (SLE) is an autoimmune disorder generally affects young to middle-aged women, commonly presenting as a triad of fever, rash, and joint pain but can affect multiple organs and can present in a complex fashion, varying based on the degree and severity of organ involvement. The differential for abdominal pain and diarrhea in SLE is vast and can include VIPomas, serositis, pancreatitis, intestinal vasculitis, and protein – losing enteropathy, gluten – enteropathy, intestinal pseudo-obstruction, and infection. The pathology of lupus enterits thought to be immune-complex deposition and complement activation, with subsequent mucosal edema. We present a case of a woman with no history of SLE, but with a prolonged course of abdominal pain, diarrhoea and vomiting and eventual diagnoses of lupus enteritis.

scholarly journals Lupus Enteritis as an Initial Presentation of Systemic Lupus Erythematosus

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Sisira Sran ◽  
Manpreet Sran ◽  
Narmisha Patel ◽  
Prachi Anand
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Status ◽  
Autoimmune Disorder ◽  
Current Treatment ◽  
Systemic Lupus ◽  
Initial Manifestation ◽  
Treatment Protocols ◽  
Multiple Organs ◽  
Lupus Enteritis

Systemic lupus erythematosus (SLE) is an autoimmune disorder which can affect multiple organs and clinical presentation is often a myriad of symptoms; therefore, the index of suspicion should rise when evaluating patients with multiorgan symptomatology. Lupus enteritis is a distinct subset of SLE, defined as either vasculitis or inflammation of the small bowel, with supportive image and/or biopsy findings. The clinical picture of lupus enteritis is often nonspecific, with mild to severe abdominal pain, diarrhea, and vomiting being the cardinal manifestations. Although considered a form of visceral or serosal vasculitis, lupus enteritis is seldom confirmed on histology, making computerized tomography (CT) the gold standard for diagnosis. Lupus enteritis is generally steroid-responsive, and the route of administration is based on clinical status and organ involvement, with preference for intravenous (IV) route in flares with significant tissue edema. The following case describes a young woman presenting with lupus enteritis and lupus panniculitis as an initial manifestation of SLE, the utilization of abdominal CT in diagnosis, and current treatment protocols used for lupus enteritis.

Lupus Enteritis, a Severe and Potentially Fatal Complication of Systemic Lupus Erythematosus

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S64-S64 ◽  
Author(s):  
Hany Meawad ◽  
Andrew Kobalka ◽  
Yaseen Alastal ◽  
Brooke Koltz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Meckel’S Diverticulum ◽  
Severe Abdominal Pain ◽  
Meckel's Diverticulum ◽  
Systemic Lupus ◽  
Gi Symptoms ◽  
Lupus Enteritis

Abstract Objectives Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can show wide manifestations in many organs. The gastrointestinal tract (GI) is commonly affected in SLE; symptoms are often related to the side effect of medications or to infections. One rare GI complication of SLE is lupus enteritis, a complex of manifestations including intestinal vasculitis and enteric ischemia, which presents with vague symptoms of severe abdominal pain, nausea, vomiting, and diarrhea. Methods We present the case of a 25-year-old female who was admitted to the hospital with complaints of abdominal pain, vomiting, diarrhea, and a history of SLE. Complicating the patient’s clinical picture and diagnosis was gastrointestinal bleeding requiring multiple blood product transfusions secondary to bleeding Meckel’s diverticulum, lupus flare, and positive stool culture for campylobacter antigen. Repeated upper and lower GI endoscopies with biopsy failed to identify the exact cause of bleeding and GI symptoms; the patient underwent exploratory laparotomy with right hemicolectomy to control bleeding. Microscopic examination revealed marked small vessel acute vasculitis consistent with lupus enteritis, ischemic enteritis, and Meckel’s diverticulum with gastric heterotopia. Results Our patient was subsequently aggressively treated; however, she developed further associated complications and died. Conclusion The pathologic diagnosis of lupus enteritis is challenging due to the nonspecific clinical symptoms and paucity of pathologic findings on most biopsy specimens. Lupus enteritis must be considered in the differential diagnosis of severe abdominal pain in lupus patients to aid in early diagnosis and treatment as this condition could be severe and potentially fatal.

scholarly journals Stercoral Colitis in a Patient With Pediatric-Onset Systemic Lupus Erythematosus: Case Analysis and Review of the Literature

2021 ◽  
Vol 9 ◽  
Author(s):  
Chun-Chun Gau ◽  
Li-Lun Lin ◽  
Chao-Yi Wu ◽  
Jing-Long Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Rare Type ◽  
Multiple Organs ◽  
First Case ◽  
Neuropsychiatric Sle ◽  
History Of ◽  
Pediatric Onset

Systemic lupus erythematosus (SLE) is an autoantibody-related disease that affects multiple organs. Stercoral colitis (SC) is a rare type of inflammatory colitis with a high mortality rate. Here, we report the first case of pediatric-onset lupus in a case complicated by stercoral colitis. We also conducted a literature review of patients with SC under 30 years old to provide useful clues for rapid diagnosis at a young age. A 28-year-old female with a history of lupus and neuropsychiatric SLE was admitted with severe abdominal pain. She was found to have stercoral colitis during surgery. Two years later, the patient underwent Hartman's operation due to ischemia of the colon. In addition, 10 patients younger than 30 years old with a diagnosis of SC were analyzed based on clinical presentation, physical examination, laboratory exam, imaging and treatment. All cases had a favorable outcome without mortality. Stercoral colitis is a rare but lethal complication, emphasizing the importance of a multidisciplinary approach. Differential diagnosis should include stercoral colitis for patients with SLE developing unexplained sharp abdominal pain.

Stercoral Colitis in a Patient with Pediatric Onset Systemic Lupus Erythematosus: Case Analysis and Review of Literature

2020 ◽  
Author(s):  
Chunchun Gau ◽  
Li-lun Lin ◽  
Chao-Yi Wu ◽  
Jing-Long Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Laboratory Data ◽  
The Elderly ◽  
Systemic Lupus ◽  
Rare Type ◽  
Multiple Organs ◽  
First Case ◽  
Pediatric Onset

Abstract Background: Systemic lupus erythematosus (SLE) is an autoantibody-related disease that affects multiple organs. Stercoral colitis (SC) is a rare type of inflammatory colitis with a high mortality rate in the elderly. We aimed to report the first case of pediatric-onset lupus in a patient complicated by stercoral colitis and to conduct a literature review of patients with SC under 30 years old to persuade a helpful clues for a rapid diagnosis in young ages.Case presentation: A 28-year-old female presented with a history of lupus, was admitted for severe abdominal pain with unremarkable laboratory data and image and was found to have stercoral colitis during the surgery. Two years later, the patient underwent Hartman’s operation due to ischemia colon. In addition, 10 patients younger than 30 years old (ranged 2 year old to 28 year old) including 7 females and 3 males with a diagnosis of SC were analyzed with clinical presentation, physical examination, laboratory exam, image and treatment. All 10 cases had a favorable outcome without mortality.Conclusions: Stercoral colitis is a rare but lethal complication and should highlight the importance of a multidisciplinary approach. The differential diagnosis should include stercoral colitis in patients with SLE developing unexplained sharp abdominal pain.

scholarly journals Lupus enteritis as a flare up of systemic lupus erythematosus- a case report and review

2021 ◽  
Vol 8 (11) ◽  
pp. 1749
Author(s):  
Niketha Janga ◽  
Jagadeesan M. ◽  
Kavitha M. M. ◽  
Kannan R.
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Acalculous Cholecystitis ◽  
Current Treatment ◽  
Colon Perforation ◽  
Common Symptom ◽  
Systemic Lupus ◽  
Treatment Protocols ◽  
Lupus Enteritis

Systemic lupus erythematosus (SLE) generally affects young to middle-aged women, commonly presenting as a triad of fever, rash, and joint pain. Abdominal pain is a common symptom in patients with SLE. The leading causes of abdominal pain in SLE are lupus enteritis, pancreatitis, pseudo-obstruction, acalculous cholecystitis, mesenteric thrombosis, hepatic thrombosis, medications like (NSAIDS, MMF, steroids, HCQ), colon perforation. The incidence of abdominal pain in patients with SLE ranges from 8-40%, and the commonest cause is lupus enteritis. The following case describes a young woman presenting with lupus enteritis as a manifestation of SLE, the importance of early disease recognition, utilities of abdominal computed tomography (CT) in diagnosis, and current treatment protocols for lupus enteritis. 

scholarly journals Chylous Ascites and Pleural Transudate: Rare Presentations in Systemic Lupus Erythematosus in Old Age

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Guan-Liang Chen ◽  
Deng-Ho Yang ◽  
Wen-Hsiu Hsu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Lupus Erythematosus ◽  
Chylous Ascites ◽  
Autoimmune Disorder ◽  
Initial Presentation ◽  
Systemic Lupus ◽  
Abdominal Sonography ◽  
Oral Ulcers ◽  
Multiple Organs

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder with involvement of multiple organs. Various forms of serositis, including pleural effusion, pericardial effusion, and ascites, may be found during the course of SLE. Peritoneal involvement by ascites is common in the initial presentation of SLE. However, chylous ascites is uncommon in SLE patients. Here, we describe a 93-year-old female with initial presentation of chylous ascites during SLE flares. Marked distention and an ovoid shape of the abdomen were observed. Shifting dullness and central tympanic sounds were found on percussion. Rales were heard in bilateral breathing sounds, multiple oral ulcers appeared in the oral cavity, and chest images showed bilateral pleural effusion. Abdominal sonography revealed moderate ascites and pleural effusion. Neither organisms nor malignant cells were revealed in the culture or cytology of ascites and pleural effusion. The diagnosis of SLE was arrived at by positive antinuclear antibody (ANA), discoid rash, oral ulcers, serositis (pleural effusion and ascites), and proteinuria. The patient received intravenous methylprednisolone 250 mg/day for three days. The pleural effusion resolved dramatically after steroid therapy and abdominal distention related to ascites formation subsided obviously.

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