Introduction: Gastrointestinal (GI) vasculitis among systemic lupus erythematosus (SLE) patients is a rare manifestation confounded with non-specific clinical symptoms and laboratory parameters which delay diagnosis leading to increase morbidity and mortality. This is a case report of a patient with of GI vasculitis who was successfully treated with belimumab Case presentation: We describe a case of a Chinese descent, 24-year-old female who was diagnosed with SLE presenting as malar rash, arthritis, intermittent fever, positive antinuclear antibody (ANA), high titer anti double-stranded DNA and low serum complement. She had gastrointestinal manifestations of colicky abdominal pain, vomiting and diarrhea, with computed tomography scan findings of diffuse mucosal edema involving both small and large intestines, with “target” sign strongly suggestive of GI vasculitis. She initially showed good response to methylprednisolone pulse therapy, but with recurrence of abdominal pain after three months. Repeat abdominal CT showed perforated viscus at the ileal segment with pneumoperitoneum, requiring emergency exploratory laparotomy and colostomy placement. Subsequent clinical course was marked by intolerance to oral steroid requiring regular administration of high dose intravenous steroids. Belimumab was started months after surgery and maintained for two years now. She was successfully shifted to oral prednisone, tapered to lowest dose and underwent uneventful intestinal reanastomosis with closure of colostomy. Discussion: Gastrointestinal (GI) vasculitis is one of the most serious gastrointestinal complications SLE presenting as acute abdominal pain. Our patient was diagnosed based on abdominal CT scan which led to an accurate diagnosis and prompt treatment. Supportive measures, surgery, and belimumab impacted the outcome of this patient. Conclusion Gastrointestinal (GI) vasculitis in SLE has a good outcome with early diagnosis and intervention. Our patient responded well with surgery, steroid and belimumab, a fully human recombinant immunoglobulin G (IgG) 1λ monoclonal antibody. This case report showed that belimumab is a good alternative treatment for lupus GI vasculitis.
Lupus Erythematosus, Systemic ; Lupus

No abstract available.
Lupus Erythematosus, Systemic*

No abstract available.
Lupus Erythematosus, Systemic*

No abstract available.
Lupus Erythematosus, Systemic*

No abstract available.
Humans ; Lupus Erythematosus, Systemic

No abstract available.
Lupus Erythematosus, Systemic*

No abstract available.
Lupus Erythematosus, Systemic*

No abstract available.
Endocarditis* ; Lupus Erythematosus, Systemic*

No abstract available.
Lupus Erythematosus, Systemic* ; Pregnancy*

Background: system lupus erythematosus (SLE) is an autoimmune disease, characterized by a variety of antibodies generated against the body itself, causing damage in all organs: skin, mucous membranes, joint-skeletal-muscle, heart, kidneys, lungs, nervous, mental, blood and lymph,... The disease progresses in waves, more and more serious and lead to death. Objectives: to study on characteristics of patients with the end stage SLE and to evaluate results of some tests in these patients. Subjectives and Method: a retrospective and cross sectional study was carried out on forty two end stage SLE patients at Department of Allergology and Clinical Immunology of Bach Mai hospital were studied between 1998 and 2004. Results: the majority of SLE patients were female (90.48%) and in group of 16-39 years old. Number of female patients was 14 times more than male patients. All 42 patients decreased peripheral blood cell amount: reducing both red and white blood cells (71.43%), reducing both three type (11.90%). 21/32 cases with severe hemoglobin reduction (65.53%). 38/42 cases of medium and severe neutropenia (90.48%). 33/42 cases with end-stage renal failure (78.57%). 13 cases of low blood Na+, 9 cases of increased blood K+. 30 cases with positive proteinuria (90.91%). 17/20 cases with pericardial effusion (85.00%). 35/42 cases with lung lesion images on ultrasound and x-rays (83.33%). 9 cases (30.00%) with increased AST and ALT above 100 U/l. 5 cases (16.67%) with meningitis. Conclusions: dramatic decrease in blood cell count, particularly in white blood cells. Most patients had renal failure at stage III, mainly with high blood potassium, and high protein and red blood cells in urine. Others included pericarditis, pneumonia, liver and neurological disorders.
Lupus Erythematosus ; Systemic/epidemiology ;