1.Gastrointestinal Vasculitis in Systemic Lupus Erythematosus: A successful treatment with Belimumab
Elaine T. Veñ ; egas ; Joenavin D. Ngo ; Sandra V. Navarra
Philippine Journal of Internal Medicine 2019;57(1):51-54
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
2.A case of systemic lupus erythematosus with verrucous endocarditis.
Jin PARK ; Wan Yong SHIN ; Il Soo KIM ; Byoung Soo CHO ; Sung Ho CHA
Journal of the Korean Society of Echocardiography 1993;1(1):139-144
No abstract available.
Endocarditis*
;
Lupus Erythematosus, Systemic*
3.Intestinal Pseudo-obstruction: Initial Manifestation of Systemic Lupus Erythematosus.
Journal of Neurogastroenterology and Motility 2011;17(4):423-424
No abstract available.
Lupus Erythematosus, Systemic
4.Relapsing lupus enteritis in systemic lupus erythematosus.
Kidney Research and Clinical Practice 2016;35(2):127-127
No abstract available.
Enteritis*
;
Lupus Erythematosus, Systemic*
5.A case of chylomicronemia syndrome in systemic lupus erythematosus.
Chul Soo CHO ; Sang Heon LEE ; Yeon Sik HONG ; Dong Jun PARK ; Ho Yeon KIM
Korean Journal of Medicine 1993;45(5):659-663
No abstract available.
Lupus Erythematosus, Systemic*
6.A Case of Psoriasis Accompanied by Systemic Lupus Erythematosus.
Eun Jee KIM ; Hyun Sun PARK ; Hyun Sun YOON ; Soyun CHO
Annals of Dermatology 2015;27(3):347-348
No abstract available.
Lupus Erythematosus, Systemic*
;
Psoriasis*
7.A Case Of Systemic Lupus Erythematosus.
Kong Youb HAN ; Jung Sue SUH ; Jung Woo SHIN
Journal of the Korean Pediatric Society 1982;25(10):1063-1067
No abstract available.
Lupus Erythematosus, Systemic*
8.The relation between the morphological multiple of FC?RIIA and systemic lupus erythematosus
Journal of Practical Medicine 2005;530(11):38-39
Study on 99 patients with systemic lupus erythematosus (SLE) who were diagnosed and treated at Dermatology hospital, and all patients had surveyed genotype of FC gamma RIIA. The control group consisted of 93 voluntary blood donors who were surveyed genotype of FCRIIA. Genotype of FCRIIA was defined by PCR-SSP method. Results: 4 PCR reactions were used to determine genotype of FCRIIA. The frequency of R/R131, R/H131 and H/H131 in 99 patients occurred in 15 (15.1%), 74 (74.1%) and 10 (10.1%), respectively and in 93 control persons were 11 (11.8%), 50 (53.8%) and 32 (34.4%), respectively. The distribution of frequency of 3 genotype between 2 groups was different with 2 = 16.16 and p<0.01. Genotype of FCRIIA could be the risk factors for the appearance of SLE in Vietnamese people.
Lupus Erythematosus, Systemic
;
Diagnosis
9.Four Cases of Childhood Systemic Lupus Erythematosus.
Jun Ah JEONG ; Young Mi KIM ; Eun Sook SUH ; Sung Ho KIM ; Chin Moo KANG ; Sang Sook LEE ; Chai Hong CHUNG
Journal of the Korean Pediatric Society 1990;33(2):264-273
No abstract available.
Lupus Erythematosus, Systemic*
10.Characteristics of age, sex and laboratory tests of patients at the end stage systemic lupus of patients at the end stage systemic lupus erythematosus in Bach mai hospital
Journal of Preventive Medicine 2007;1(17):50-55
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
;