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Bowel perforation and interstitial cystitis in childhood systemic lupus erythematosus

A Eberhard1, A Shore, E Silverman

  • 1Department of Pediatrics, Hospital for Sick Children, University of Toronto, ON, Canada.

The Journal of Rheumatology
|May 1, 1991
PubMed

Insights

Systemic lupus erythematosus (SLE) in a young girl led to severe gastrointestinal issues and interstitial cystitis. Despite intensive treatment, a fatal small bowel perforation occurred, highlighting poor prognosis in SLE patients with this complication.

Area of Science:

  • Pediatric Rheumatology
  • Gastroenterology
  • Urology

Background:

  • Systemic lupus erythematosus (SLE) is a complex autoimmune disease.
  • Gastrointestinal and urinary tract involvement can occur in SLE patients.
  • Early diagnosis and management are crucial for SLE patients.

Observation:

  • A 13-year-old female presented with abdominal pain, fever, dysuria, incontinence, and pyuria.
  • The patient was diagnosed with SLE exhibiting extensive gastrointestinal involvement and interstitial cystitis.
  • Despite high-dose prednisone and cyclophosphamide therapy, she developed a small bowel perforation.

Findings:

  • The combination of gastrointestinal symptoms and interstitial cystitis is a rare presentation in SLE.
  • Small bowel perforation in SLE patients carries an extremely poor prognosis.
  • Aggressive immunosuppressive therapy did not prevent fatal complications in this case.

Implications:

  • This case underscores the potential for severe gastrointestinal and urinary complications in pediatric SLE.
  • The unique presentation highlights the need for heightened vigilance in SLE patients with combined bowel and bladder symptoms.
  • Further research into the pathogenesis and management of gastrointestinal complications in SLE is warranted.

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