Enthesitis in a Patient with Systemic Lupus Erythematosus: The First Case Report.
- Author:
Hyungjin KIM
1
;
Jaejoon LEE
;
Joong Kyong AHN
;
Ji Won HWANG
;
Jung Won NOH
;
Eun Mi KOH
;
Hoon Suk CHA
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hoonsuk.cha@samsung.com
- Publication Type:Case Report
- Keywords:
Lupus Erythematosus;
Systemic;
Enthesopathy
- MeSH:
Adult;
Antiphospholipid Syndrome;
Arthritis, Psoriatic;
Arthritis, Reactive;
Collodion;
Fascia;
Female;
Humans;
Inflammatory Bowel Diseases;
Joint Capsule;
Ligaments;
Low Back Pain;
Lupus Erythematosus, Systemic;
Lupus Nephritis;
Magnetic Resonance Imaging;
Osteitis;
Rheumatic Diseases;
Sclerosis;
Spine;
Spondylarthropathies;
Spondylitis, Ankylosing;
Tendons;
Thrombosis
- From:Korean Journal of Medicine
2011;80(2):243-246
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present the first case of enthesitis in the lumbar spine in a woman with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Enthesopathy is defined as pathological alterations at the site of insertion of a tendon, ligament, joint capsule, or fascia to bone. In particular, enthesitis is the universal hallmark of seronegative spondyloarthropathies (SpA), including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and spondyloarthropathies associated with inflammatory bowel diseases. A 36-year-old female SLE patient with a history of lupus nephritis and thrombosis from APS presented with low back pain that had been gradually worsening for several months. She reported no previous episodes of trauma. Plain radiography indicated sclerosis at the anterior superior bodies of L3 and L5. Magnetic resonance imaging (MRI) showed low-intensity lesions on T1-weighted images and high-intensity lesions on T2-weighted images at the anterior superior bodies of L3, L4, and L5, consistent with osteitis or enthesitis. A nonsteroidal antiinflammatory drug (NSAID) was used as the first-line therapy in this patient, which improved her symptoms. This is the first report of enthesitis in the context of SLE. Although the possibility of coincidental occurrence of SpA and SLE cannot be excluded, the observations in this case suggest that enthesitis may be one of the manifestations of SLE.
