The 452th case:rash, hypotension, abdominal pain and headache

VernacularTitle:第452例——皮疹、低血压、腹痛、头痛
Author: Sainan BIAN ; Huaxia YANG ; Qian WANG ; Dong XU ; Yan ZHAO
Publication Type:Journal Article
Keywords: Lupus erythematosus,systemic; Acalculous cholecystitis
From: Chinese Journal of Internal Medicine 2016;55(9):741-744
CountryChina
Language:Chinese
Abstract: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized with multiple organ involvements.Acute acalculous cholecystitis (AAC) is an extremely rare manifestation of digestive system involvement in SLE.We reported a case of 32-year-old woman who complained skin rashes for two weeks and stomachache and oliguria for one day.She had rashes at onset,and developed fever,stomachache,hypotension and headache.Physical examination at admission indicated blood pressure 76/47mmHg(1 mmHg =0.133 kPa),heart rate 107 beats/min,warm acra.Murphy's sign was positive.Ultrasound suggested the enlarged gallbladder with surrounding hypoecho band yet no biliary calculi were found.A diagnosis of SLE was made,characteristic with distributive shock at the onset and AAC,complicated with neuropsychiatric lupus and lupus nephritis.She had an acute and severe course of disease,which had been relieved after treatment of high dose glucocorticoid and immunosuppressants.This case arouses clinicians to pay more attention to AAC as a rare form of disease flare in SLE.Early diagnosis of AAC is crucial to a favorable prognosis and in avoid of abdominal surgery.