Gastrointestinal system involvement in systemic lupus erythematosus.

Area of Science:

• Gastroenterology
• Rheumatology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease.
• Gastrointestinal (GI) involvement occurs in up to 50% of SLE patients.
• SLE-related GI complications are under-reviewed due to diagnostic challenges.

Purpose of the Study:

• To clarify clinical characteristics, diagnosis, and treatment of four major SLE-related GI complications.
• Focus areas include protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), hepatic involvement, and pancreatitis.
• To provide a comprehensive review of SLE's impact on the GI system.

Main Methods:

• Systematic review of MEDLINE and EMBASE databases.
• Search terms included SLE, PLE, IPO, hepatitis, and pancreatitis.
• Analysis of 125 selected articles.

Main Results:

• SLE-related PLE presents with edema and hypoalbuminemia; diagnosis utilizes 99mTc HAS and fecal alpha-1-antitrypsin clearance.
• SLE-related IPO often co-occurs with ureterohydronephrosis, interstitial cystitis, and hepatobiliary dilatation.
• Lupus hepatitis differs from SLE-AIH overlap in autoantibodies and histology; anti-ribosome P antibody suggests lupus hepatitis. Lupus pancreatitis has high mortality and correlates with SLE activity.

Conclusions:

• Early diagnosis and prompt intervention are vital for SLE-related GI complications.
• Corticosteroids and immunosuppressants are effective treatments for most patients.
• Understanding these specific GI manifestations improves SLE patient management.