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Panenteritis as an Initial Presentation of Systemic Lupus Erythematosus
Han Ah Lee1, Hye Gi Shim2, Young Ho Seo1
1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|February 25, 2016
Summary
Lupus enteritis, a severe complication of systemic lupus erythematosus (SLE), often presents with non-specific gastrointestinal symptoms, leading to delayed diagnosis. Prompt recognition and treatment are crucial for managing this rare condition.
Area of Science:
- Gastroenterology
- Rheumatology
- Internal Medicine
Background:
- Lupus enteritis is a rare but severe gastrointestinal complication of systemic lupus erythematosus (SLE).
- It frequently presents with non-specific abdominal symptoms, complicating early diagnosis.
- SLE rarely manifests initially as lupus enteritis, increasing the risk of misdiagnosis.
Observation:
- A case of lupus panenteritis in a 25-year-old woman is presented.
- Initial symptoms included abdominal pain, nausea, and diarrhea, without clear SLE indicators.
- Subsequent development of malar rash and oral ulcers, alongside positive antinuclear antibody, supported the SLE diagnosis.
Findings:
- Computed tomography (CT) revealed diffuse submucosal thickening throughout the stomach, small bowel, colon, appendix, and rectum.
- Laboratory findings were consistent with SLE, including a speckled antinuclear antibody pattern (1:320).
Implications:
- Diagnosis of lupus enteritis necessitates a high index of suspicion due to its rarity and nonspecific presentation.
- Effective management involves high-dose corticosteroids and immunosuppressive maintenance therapy (e.g., mycophenolate mofetil, hydroxychloroquine, azathioprine).
- This case highlights the importance of considering SLE in patients with unexplained, extensive gastrointestinal inflammation.
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