Recurrent lupus mesenteric vasculitis leading to gastrointestinal perforation and sepsis
Recurrent lupus mesenteric vasculitis leading to gastrointestinal perforation and sepsis
复制标题
复发性狼疮肠系膜血管炎导致胃肠道穿孔和败血症
DOI：
10.1016/j.kjms.2015.04.007
复制
发表时间：
2015
影响因子：
3.3
通讯作者：
Y. Chiou
中科院分区：
文献类型：
--
作者：
Ying;I. Huang;Wen‐Bin Feng;Y. Chiou
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems. Gastrointestinal (GI) manifestations are not included in the diagnostic criteria of SLE, but frequently affect SLE patients. There are various GI manifestations, including anorexia, nausea, and vomiting. The etiologies vary, such as lupus mesenteric vasculitis (LMV) and serositis secondary to lupus itself, side effects of SLE medication, or coincidence of GI diseases like appendicitis, pancreatitis, or acute viral or bacterial enterocolitis. Diagnosing the cause of GI symptoms in patients with SLE is a challenge for clinicians. However, LMV should be considered if all other etiologies have been excluded. Here is a case of a patient with SLE presenting as recurrent abdominal pain and with poor prognosis. A 15-year-old girl had a history of SLE with class IV lupus nephritis and lupus nephritis-related secondary hypertension. On the first admission, she had abdominal pain for 2 weeks with fever, tarry stool, and vomiting for 4e5 days. Physical examination showed diffuse tenderness over the abdominal wall, without rebound tenderness or muscle guarding. Abdominal computed tomography (CT) revealed segmental mural thickening of the proximal jejunum. Acute segmental obstructive enteritis (ASOE), mesenteric vasculitis related, was highly suspected. As an SLE flare-up was favored, intravenous methylprednisolone (500 mg/d) was administered for 3 days. She was discharged in a stable condition, with oral prednisolone (1 mg/kg/d) as a maintenance treatment. However, she was re-admitted after 3 days with similar conditions, which were resolved with intravenous steroids.
