How to diagnose lupus enteritis early? Lessons learned from a multicenter case series

Area of Science:

• Gastroenterology
• Rheumatology
• Medical Imaging

Background:

• Lupus enteritis (LE) is a severe, uncommon manifestation of systemic lupus erythematosus (SLE).
• Timely diagnosis of LE is critical to prevent life-threatening complications like bowel infarction and peritonitis.

Observation:

• This case review analyzed seven patients diagnosed with LE across three tertiary SLE centers.
• Patients presented with acute abdominal pain, nausea, and vomiting; LE was the initial SLE manifestation in two cases.
• Key serological markers included high anti-dsDNA antibodies and low complement levels.

Findings:

• Abdominal ultrasound revealed characteristic findings: bowel wall thickening, intestinal dilatation, increased mesenteric fat reflectivity, and mild ascites.
• These ultrasound findings raised suspicion for LE, prompting immediate treatment.
• CT scans confirmed LE in five patients, validating ultrasound's diagnostic utility.

Implications:

• LE should be considered in SLE patients experiencing gastrointestinal distress.
• Abdominal ultrasound serves as a valuable and reliable initial diagnostic tool for lupus enteritis.
• Early ultrasound detection facilitates prompt management and improves patient outcomes in SLE.