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Mesenteric vasculitis in children with systemic lupus erythematosus
Lampros Fotis1, Kevin W Baszis2, Anthony R French2
1Pediatric Rheumatology Division, St. Louis Children's Hospital, Washington University in St. Louis, One Children's Place, St Louis, MO, 63110, USA. fotis_l@kids.wustl.edu.
Clinical Rheumatology
|February 18, 2015
Summary
Lupus mesenteric vasculitis (LMV) in young patients with systemic lupus erythematosus (SLE) presents diagnostic and management challenges. Early diagnosis and combined immunosuppressive therapy improve survival and remission rates.
Area of Science:
- Rheumatology
- Immunology
- Gastroenterology
Background:
- Lupus mesenteric vasculitis (LMV) is a severe complication of systemic lupus erythematosus (SLE).
- Diagnosis and management of LMV in adolescents and adults with SLE presenting with acute abdominal pain are challenging.
- LMV requires prompt recognition and treatment to prevent potentially fatal outcomes.
Observation:
- This study describes five adolescent and young adult patients (ages 14-21) diagnosed with LMV.
- All patients presented with active SLE and symptoms suggestive of LMV.
- Abdominal CT scans were utilized for diagnosis, proving useful in four cases.
Findings:
- Corticosteroids formed the primary treatment for all patients.
- Four out of five patients achieved complete remission with the addition of cyclophosphamide.
- One patient achieved remission with the addition of rituximab.
- All five patients survived the acute episode.
Implications:
- LMV is a critical consideration in SLE patients with acute abdominal pain.
- Aggressive immunosuppressive therapy, including cyclophosphamide or rituximab, can lead to favorable outcomes.
- Further research into optimal LMV management strategies is warranted.
