Case Report

Gastrointestinal Manifestation of Systemic Lupus Erythematosus - Lupus Enteritis

DOI https://doi.org/10.70302/jpsim.v4i1.2312
Received: 22 Oct 2022 Accepted: 23 Nov 2022 Published Online: 13 Feb 2023

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disorder with a heterogenous mode of presentation and clinical course. We present a case of a young female with an atypical presentation of SLE. A young woman with no known prior comorbidities presenting with the history of chronic diarrhea, vomiting and weight loss, followed by generalized weakness. Extensive workup was done and she was diagnosed with lupus enteritis based on history, laboratory investigations and findings on imaging. She was given pulse therapy to which she responded very well. The case describes the importance of high clinical suspicion and timely intervention as well as adds to the evidence on a rare clinical entity- lupus enteritis.

Keywords
SLE Lupus enteritis autoimmune disorders chronic diarrhea

How to Cite This Article

Raees A, Parkash O, Sohail Z. Gastrointestinal Manifestation of Systemic Lupus Erythematosus - Lupus Enteritis. J Pak Soc Intern Med. 2023;4(1):56–59. doi:10.70302/jpsim.v4i1.2312

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Von Feldt JM. Systemic lupus erythematosus: recognizing its various presentations. Postgraduate medicine. 1995;97(4):79-94.
  2. . Osler W. On the visceral complications of erythema exudativum multiforme. Am J Med Sci (1827-1924). 1895;110(6):629.
  3. . Tian XP, Zhang X: Gastrointestinal involvement in systemic lupus erythematosus: Insight into pathogenesis, diagnosis and treatment. World J Gastroenterol. 2010;16(10):2971-7.
  4. . Isenberg DA, Rahman A, Allen E, Farewell V, Akil M, Bruce IN, D’Cruz D, Griffiths B, Khamashta M, Maddison P, McHugh N, Snaith M, Teh LS, Yee CS, Zoma A, Gordon C: BILAG 2004. Development and initial validation of an updated version of the British Isles Lupus Assessment Group’s disease activity index for patients with systemic lupus erythematosus. Rheumatology (Oxford) 2005;44(6):902-6.
  5. . Brewer BN, Kamen DL. Gastrointestinal and Hepatic Disease in Systemic Lupus Erythematosus. Rheum Dis Clin North Am 2018; 44(2):165-75
  6. . Kwok S-K, Seo S-H, Ju JH, et al. Lupus enteritis: clinical characteristics, risk factor for relapse and association with anti-endothelial cell antibody. Lupus. 2007;16(10):803-809
  7. . Lee HA, Shim HG, Seo YH, Choi SJ, Lee BJ, Lee YH, et al. Panenteritis as an Initial Presentation of Systemic Lupus Erythematosus. Korean J Gastroenterol Taehan Sohwagi Hakhoe Chi. 2016; 67 (2): 107-11
  8. . Hoffman BI, Katz WA. The gastrointestinal manifestations of systemic lupus erythematosus: a review of the literature. Semin Arthritis Rheum. 1980;9(2):237-47
  9. . Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(10): 2677-86.
  10. . Janssens P, Arnaud L, Galicier L, Mathian A, Hie M, Sene D, Haroche J, Veyssier-Belot C, et al: Lupus enteritis: from clinical findings to therapeutic management. Orphanet J Rare Dis. 2013;8(1):67.
  11. .Lee C-K, Ahn MS, Lee EY, Shin JH, Cho Y-S, Ha HK, Yoo B, Moon H-B: Acute abdominal pain in systemic lupus erythematosus: focus on lupus enteritis (gastrointestinal vasculitis). Ann Rheum Dis. 2002;61(3):547-50.
  12. . Demiselle J, Sayegh J, Cousin M, Olivier A, Augusto JF. An Unusual Cause of Abdominal Pain: Lupus Enteritis. Am J Med 2016; 129(1): e11-e12.
  13. . Waite L, Morrison E. Severe gastrointestinal involvement in systemic lupus erythematosus treated with rituximab and cyclophosphamide (B-cell depletion therapy) Lupus. 2007;16(6):841-2.
  14. . Kim YG, Ha HK, Nah SS, et al. Acute abdominal pain in systemic lupus erythematosus: factors contributing to recurrence of lupus enteritis. Ann Rheum Dis. 2006;65(6):1537-8.
  15. . Liu Z, Guo M, Cai Y, Zhao Y, Zeng F, Liu Y. A nomogram to predict the risk of lupus enteritis in systemic lupus erythematosus patients with gastroinctestinal involvement. E Clin Med. 2021;36(6):100900.

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