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Colonic perforations in systemic lupus erythematosus.

T M Zizic, L E Shulman, M B Stevens

    Medicine
    |September 1, 1975
    PubMed
    Summary

    Systemic lupus erythematosus (SLE) patients experiencing severe abdominal pain may have colonic perforations. This serious complication, often linked to arteritis, was a frequent cause of death in SLE patients.

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    Area of Science:

    • Rheumatology
    • Gastroenterology
    • Pathology

    Background:

    • Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations.
    • Gastrointestinal involvement in SLE can be severe and life-threatening.
    • Colonic perforation is a rare but critical complication in SLE patients.

    Observation:

    • Five SLE patients presented with colonic perforations; four died.
    • Active SLE, arteritis (including gastrointestinal), and abdominal syndrome were noted in all cases.
    • Abdominal pain was insidious, intermittent, and colicky, with variable tenderness and bowel sounds.

    Findings:

    • Colonic perforation was the most frequent cause of death among 107 SLE patients over three years.
    • Active arteritis involving multiple organ systems was present in all patients with colonic perforation.
    • Laboratory findings included hyperglobulinemia, rheumatoid factor, and antinuclear antibodies.

    Implications:

    • The findings highlight colonic perforation as a significant cause of mortality in SLE.
    • Mesenteric arteritis, potentially triggered by immune complexes and rheumatoid factors, is implicated in the pathogenesis.
    • Early recognition and management of abdominal complications in SLE are crucial for improving patient outcomes.

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