Panenteritis as an Initial Presentation of Systemic Lupus Erythematosus.
10.4166/kjg.2016.67.2.107
- Author:
Han Ah LEE
1
;
Hye Gi SHIM
;
Young Ho SEO
;
Sung Jae CHOI
;
Beom Jae LEE
;
Young Ho LEE
;
Jong Dae JI
;
Jae Hoon KIM
;
Gwan Gyu SONG
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. visionkjh@naver.com
- Publication Type:Case Reports
- Keywords:
Systemic lupus erythematosus;
Enteritis
- MeSH:
Abdominal Pain/complications;
Adrenal Cortex Hormones/therapeutic use;
Adult;
Brain/diagnostic imaging;
Diagnosis, Differential;
Diarrhea/complications;
Endoscopy, Gastrointestinal;
Enteritis/pathology;
Female;
Humans;
Lupus Erythematosus, Systemic/complications/*diagnosis/drug therapy;
Magnetic Resonance Imaging;
Nausea/complications;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2016;67(2):107-111
- CountryRepublic of Korea
- Language:English
-
Abstract:
Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE), needing prompt diagnosis and proper management. However, SLE rarely presents as lupus enteritis at the time of initial diagnosis. Thus, delayed diagnosis and misdiagnosis are common. We report a case of a 25-year-old woman with lupus panenteritis. The patient had multiple hospitalizations for abdominal pain, nausea, and diarrhea, initially without any other symptoms suggestive of SLE, but was later observed to have malar rash and oral ulcers. Laboratory investigations were compatible with SLE, including positive antinuclear antibody (1:320) with speckled pattern. CT revealed diffuse hypodense submucosal thickening of the stomach, the entire small bowel, colon, appendix, and rectum. Treatment with high-dose corticosteroids followed by maintenance therapy with mycophenolate mofetil, hydroxychloroquine, and azathioprine resulted in clinical improvement. Diagnosis of lupus enteritis requires a high index of suspicion given the low incidence and nonspecific clinical findings.
