Acute abdominal pain in systemic lupus erythematosus: focus on lupus enteritis (gastrointestinal vasculitis)
Acute abdominal pain in systemic lupus erythematosus: focus on lupus enteritis (gastrointestinal vasculitis)
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DOI：
10.1136/ard.61.6.547
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发表时间：
2002-06-01
影响因子：
27.4
通讯作者：
Moon, HB
中科院分区：
文献类型：
--
作者：
Lee, CK;Ahn, MS;Moon, HB
目的：明确系统性红斑狼疮（SLE）急性腹痛的原因，比较狼疮性肠炎（胃肠道血管炎）与不伴狼疮性肠炎的SLE患者的临床和实验室数据，特别是抗磷脂抗体和SLE疾病活动指数（SLEDAI）。方法：对1993年至2001年3月收治的所有SLE患者进行回顾性研究。在诊断 SLE 时和出现急性腹痛时收集 SLEDAI 和实验室数据。狼疮性肠炎（胃肠道血管炎）通过临床调查和腹部计算机断层扫描结果诊断。结果：图表审查确定了 175 名因 SLE 入院的患者（20 名男性，155 名女性）。在这些患者中，38 名 (22%) 出现急性腹痛。狼疮性肠炎是急性腹痛的最常见原因，患者被分为三组：第1组：狼疮性肠炎（n=17），第2组：无狼疮性肠炎的急性腹痛（n=21），以及第3组：无急性腹痛的SLE（n=137）。三组之间的年龄和性别没有差异。抗磷脂、抗RNP、抗Sm、抗Ro和抗La抗体在三组之间没有差异。第1组和第2组在诊断时和急性腹痛时的SLEDAI没有差异。在急性腹痛时测量的补体、红细胞沉降率、C反应蛋白和抗dsDNA在第1组和第2组之间没有差异。腹痛时白细胞计数的下降在第1组中比第2组更明显。在狼疮性肠炎中，空肠和回肠是发生部位最常受累，直肠受累罕见。尽管有 4 名患者复发，但所有狼疮性肠炎患者（包括复发患者）对皮质类固醇的反应良好。结论：狼疮性肠炎是 SLE 急性腹痛的最常见原因。所有狼疮性肠炎患者对高剂量皮质类固醇反应良好，无需手术干预。除白细胞减少外，SLEDAI 和实验室数据与狼疮性肠炎的发生无关。
Objective: To determine the causes of acute abdominal pain in systemic lupus erythematosus (SLE) and to compare the clinical and laboratory data, especially antiphospholipid antibodies and the SLE Disease Activity Index (SLEDAI), between lupus enteritis (gastrointestinal vasculitis) and acute abdominal pain without lupus enteritis in patients with SLE.Methods: A retrospective study was carried out for all patients admitted with SLE from 1993 to March 2001. The SLEDAI and laboratory data were collected at the time of diagnosis of SLE and at the time of acute abdominal pain. Lupus enteritis (gastrointestinal vasculitis) was diagnosed by clinical investigation and abdominal computed tomographic findings.Results: Chart review identified 175 patients (20 male, 155 female) who had been admitted with SLE. Of these patients, 38 (22%) presented with acute abdominal pain. Lupus enteritis was the most common cause of acute abdominal pain, Patients were divided into three groups: group 1 : lupus enteritis (n=17), group 2: acute abdominal pain without lupus enteritis (n=21), and group 3: SLE without acute abdominal pain (n=137). There was no difference in age and sex among the three groups. Antiphospholipid, anti-RNP, anti-Sm, anti-Ro, and anti-La antibodies did not differ among the three groups. There was no difference in the SLEDAI at the time of diagnosis and at the time of acute abdominal pain between groups 1 and 2. Complement, erythrocyte sedimentation rate, C reactive protein, and anti-dsDNA measured at the time of acute abdominal pain did not differ between groups 1 and 2. A drop in the white blood cell count at the time of abdominal pain was more prominent in group 1 than group 2. In lupus enteritis, the jejunum and ileum were the sites most commonly affected, Rectal involvement was rare. Even though four patients relapsed, all the patients with lupus enteritis, including those who relapsed, responded well to corticosteroid.Conclusion: Lupus enteritis is the most common cause of acute abdominal pain in SLE. All patients with lupus enteritis responded well to a high dose of a corticosteroid without surgical intervention. The SLEDAI and laboratory data except leucopenia, do not correlate with the occurrence in lupus enteritis.