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Lupus-associated pancreatitis.

Gideon Nesher1, Gabriel S Breuer, Katherine Temprano

  • 1Department of Internal Medicine A, Rheumatology Service, Shaare-Zedek Medical Center, Jerusalem, Israel. rheum@szmc.org.il

Seminars in Arthritis and Rheumatism
|February 8, 2006
PubMed
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Pancreatitis is a rare complication of systemic lupus erythematosus (SLE). Early suspicion in SLE patients with abdominal pain and prompt treatment with steroids or azathioprine can improve outcomes.

Area of Science:

  • Rheumatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Pancreatic involvement in SLE is uncommon but can lead to significant morbidity and mortality.

Observation:

  • This review analyzed 77 cases of lupus-associated pancreatitis over 30 years.
  • The majority of patients were female (88%), with a median age of 27.
  • Pancreatitis often occurred within the first year of SLE diagnosis, with 84% experiencing active lupus concurrently.

Findings:

  • Abdominal pain (88%) and nausea/vomiting (67%) were the most common symptoms.
  • Diagnosis relied on elevated serum amylase/lipase (97%), though imaging was not always conclusive.

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  • The overall mortality rate was 27%, associated with active lupus and specific biochemical markers.

    • Implications:

    • Pancreatitis should be considered in SLE patients presenting with abdominal pain.
    • Treatment with corticosteroids or azathioprine post-pancreatitis onset was linked to reduced mortality.
    • Early diagnosis and management are crucial for improving prognosis in lupus-associated pancreatitis.