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 associated with pregnancy.
Keun Jai YOO ; Soo Nyung KIM ; In Jae CHO ; Doo Ho KIM ; Kyung Soo KIM
Korean Journal of Obstetrics and Gynecology 1993;36(9):3508-3516
No abstract available.
Lupus Erythematosus, Systemic*
;
Pregnancy*
3.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
4.Diagnosis and treatment of systemic lupus erythematosus.
Korean Journal of Medicine 2010;78(4):437-443
No abstract available.
Lupus Erythematosus, Systemic
5.Cutaneous Manifestations of Childhood Systemic Lupus Erythematosus.
Mi Woo LEE ; Jee Ho CHOI ; kyung Jeh SUNG ; Kee Chan MOON ; Jai Kyoung KOH
Korean Journal of Dermatology 2000;38(5):607-611
No Abstract Available.
Lupus Erythematosus, Systemic*
6.Preliminary Study of Early Organ Damage in Systemic Lupus Erythematosus.
Ja Hun JUNG ; Sang Cheol BAE ; Yong Ho SONG ; Tae Hwan KIM ; Jae Bum JUN ; Sung Soo JUNG ; In Hong LEE ; Dae Hyun YOO ; Seong Yoon KIM
The Journal of the Korean Rheumatism Association 1998;5(2):177-186
No abstract available.
Lupus Erythematosus, Systemic*
7.Relapsing lupus enteritis in systemic lupus erythematosus.
Kidney Research and Clinical Practice 2016;35(2):127-127
No abstract available.
Enteritis*
;
Lupus Erythematosus, Systemic*
8.Management of systemic lupus erythematosus.
Korean Journal of Medicine 2004;67(1):1-6
No abstract available.
Lupus Erythematosus, Systemic*
9.Herpetic Whitlow in Patient with Systemic Lupus Erythematosus.
The Journal of the Korean Rheumatism Association 2010;17(4):457-458
No abstract available.
Humans
;
Lupus Erythematosus, Systemic
10.A Case of Systemic Lupus Erythematosus.
Dong Hwan CHO ; Sook Kyeung ZUNG ; Zun Ho KIM ; Byung Yun CHUNG ; Won Jae PARK
Journal of the Korean Pediatric Society 1982;25(11):1185-1189
No abstract available.
Lupus Erythematosus, Systemic*